Provider Demographics
NPI:1134235328
Name:SCHULTZ, MELBA RENEE (DC)
Entity type:Individual
Prefix:DR
First Name:MELBA
Middle Name:RENEE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 W LOVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-2629
Mailing Address - Country:US
Mailing Address - Phone:513-722-5415
Mailing Address - Fax:
Practice Address - Street 1:1924 W LOVELAND AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-2629
Practice Address - Country:US
Practice Address - Phone:513-722-5415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3281111N00000X
IL171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
205798Medicare ID - Type Unspecified
IL04232005OtherBCBS