Provider Demographics
NPI:1639462146
Name:SCHUETZ, JUSTIN DON (BA)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:DON
Last Name:SCHUETZ
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 E CENTENNIAL PKWY
Mailing Address - Street 2:#7353
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-8114
Mailing Address - Country:US
Mailing Address - Phone:702-994-0388
Mailing Address - Fax:
Practice Address - Street 1:2929 E CENTENNIAL PKWY
Practice Address - Street 2:#7353
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-8114
Practice Address - Country:US
Practice Address - Phone:702-994-0388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner