Provider Demographics
NPI:1689930752
Name:SCHULTZ, ERIC DEAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DEAN
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E BROADWAY
Mailing Address - Street 2:SUITE 340
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-4208
Mailing Address - Country:US
Mailing Address - Phone:573-268-4524
Mailing Address - Fax:
Practice Address - Street 1:111 E BROADWAY
Practice Address - Street 2:SUITE 340
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4208
Practice Address - Country:US
Practice Address - Phone:573-268-4524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20100281792251E1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics