Provider Demographics
NPI:1952610685
Name:SCHULTZ, JEREMY JAMES (DC)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:JAMES
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 W 57TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2711
Mailing Address - Country:US
Mailing Address - Phone:605-362-1225
Mailing Address - Fax:605-362-9525
Practice Address - Street 1:1919 W 57TH ST STE 103
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2711
Practice Address - Country:US
Practice Address - Phone:605-362-1225
Practice Address - Fax:605-362-9525
Is Sole Proprietor?:No
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1179111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor