Provider Demographics
NPI:1700544863
Name:SCHULTZ, CARTER
Entity Type:Individual
Prefix:
First Name:CARTER
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 NE 3RD ST STE 106-16
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3894
Mailing Address - Country:US
Mailing Address - Phone:703-579-7414
Mailing Address - Fax:541-323-8786
Practice Address - Street 1:1230 NE 3RD ST STE A152
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4376
Practice Address - Country:US
Practice Address - Phone:541-241-2976
Practice Address - Fax:541-323-8786
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6190111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor