MEDICARE: MR. JOHN F. SCHULTZ D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	3622	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200769476	OTHER	CO	TAX I.D.

General Provider Information

NPI Number	:	1528157716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN F. SCHULTZ D.C.

Provider Business Mailing Address
First Line	:	1715 IRON HORSE DR
Second Line	:	STE 122
City	:	LONGMONT
State	:	CO
Zip	:	80501-9758
Country	:	US
Telephone Number	:	720-494-4790
Fax Number	:	720-494-4791

Provider Business Practice Location Address
First Line	:	1551 PROFESSIONAL LN UNIT 180
Second Line	:
City	:	LONGMONT
State	:	CO
Zip	:	80501-6970
Country	:	US
Telephone Number	:	720-494-4790
Fax Number	:	720-494-4791

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	12/02/2016

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Directions to “ MR. JOHN F. SCHULTZ D.C.” Practice Location

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