Provider Demographics
NPI:1376845248
Name:SCHULTZ, JODI (OD)
Entity Type:Individual
Prefix:DR
First Name:JODI
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:673 CONESTOGA TRD
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-2939
Mailing Address - Country:US
Mailing Address - Phone:610-520-1342
Mailing Address - Fax:
Practice Address - Street 1:129 N WAYNE AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-3561
Practice Address - Country:US
Practice Address - Phone:106-881-1121
Practice Address - Fax:610-688-4554
Is Sole Proprietor?:No
Enumeration Date:2010-11-29
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE008365T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist