Provider Demographics
NPI:1124884945
Name:SCHULTZ, AUSTIN DAVID (DC)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:DAVID
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 1:135 RIDGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-2039
Mailing Address - Country:US
Mailing Address - Phone:864-477-9575
Mailing Address - Fax:
Practice Address - Street 1:258 EASTGATE DR STE 5
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-7698
Practice Address - Country:US
Practice Address - Phone:803-618-4192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5003111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor