Provider Demographics
NPI:1831122092
Name:SCHUTZ, JOHN GREGORY II (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:GREGORY
Last Name:SCHUTZ
Suffix:II
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 1:1240 10TH AVE. SW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-3432
Mailing Address - Country:US
Mailing Address - Phone:319-352-2425
Mailing Address - Fax:
Practice Address - Street 1:1240 10TH AVE. SW
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-0209
Practice Address - Country:US
Practice Address - Phone:319-352-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNA05690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1101394Medicaid
IAI17098Medicare ID - Type Unspecified
IAU41329Medicare UPIN