Provider Demographics
NPI:1891274890
Name:SCHULZ, NICHOLAS DAVID (OTR/L)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:DAVID
Last Name:SCHULZ
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5514 LORI LN W
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8557
Mailing Address - Country:US
Mailing Address - Phone:218-252-2628
Mailing Address - Fax:
Practice Address - Street 1:5514 LORI LN W
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8557
Practice Address - Country:US
Practice Address - Phone:218-252-2628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
ND1796225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist