Provider Demographics
NPI:1750735270
Name:SCHULTZ, ANDREW (ATC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N CARROLL ST
Mailing Address - Street 2:APT 705
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-1346
Mailing Address - Country:US
Mailing Address - Phone:920-850-1858
Mailing Address - Fax:
Practice Address - Street 1:550 14TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122
Practice Address - Country:US
Practice Address - Phone:206-296-5620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer