Provider Demographics
NPI:1669742359
Name:SCHULZ, SCOTT FREDERICK ALLEN (LAC)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:FREDERICK ALLEN
Last Name:SCHULZ
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 CANDLEWOOD CMNS
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2173
Mailing Address - Country:US
Mailing Address - Phone:732-901-3001
Mailing Address - Fax:732-901-3105
Practice Address - Street 1:602 CANDLEWOOD CMNS
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2173
Practice Address - Country:US
Practice Address - Phone:732-901-3001
Practice Address - Fax:732-901-3105
Is Sole Proprietor?:No
Enumeration Date:2012-01-11
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00113900171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist