Provider Demographics
NPI:1497942122
Name:JOHN F. SCHULTZ D.C. P.C.
Entity Type:Organization
Organization Name:JOHN F. SCHULTZ D.C. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC, FIAMA
Authorized Official - Phone:720-494-4790
Mailing Address - Street 1:1551 PROFESSIONAL LN UNIT 180
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-6970
Mailing Address - Country:US
Mailing Address - Phone:720-494-4790
Mailing Address - Fax:720-494-4791
Practice Address - Street 1:1551 PROFESSIONAL LN UNIT 180
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-6970
Practice Address - Country:US
Practice Address - Phone:720-494-4790
Practice Address - Fax:720-494-4791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3622302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC527298Medicare UPIN
COC528038Medicare PIN