Provider Demographics
NPI:1194615351
Name:SCHULTZ, MIRANDA JEAN (DC)
Entity type:Individual
Prefix:DR
First Name:MIRANDA
Middle Name:JEAN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 BLUFF ST UNIT 306
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2196
Mailing Address - Country:US
Mailing Address - Phone:724-467-0416
Mailing Address - Fax:
Practice Address - Street 1:2449 PINE ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-4610
Practice Address - Country:US
Practice Address - Phone:303-998-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008939111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor