Provider Demographics
NPI:1164605507
Name:SCHULTZ, DOUGLAS RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:RYAN
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16425 E PALISADS BLVD #105
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-3833
Mailing Address - Country:US
Mailing Address - Phone:480-837-4444
Mailing Address - Fax:
Practice Address - Street 1:16425 E PALISADES BLVD STE 105
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-3754
Practice Address - Country:US
Practice Address - Phone:480-837-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-07
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7876111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor