Provider Demographics
NPI:1306997689
Name:SCHILTZ, THOMAS JOSEPH (DC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOSEPH
Last Name:SCHILTZ
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 1:4214 FLEUR DR STE 4
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50321-2300
Mailing Address - Country:US
Mailing Address - Phone:515-285-4000
Mailing Address - Fax:515-285-7281
Practice Address - Street 1:4214 FLEUR DR STE 4
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50321-2300
Practice Address - Country:US
Practice Address - Phone:515-285-4000
Practice Address - Fax:515-285-7281
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05756111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1108894Medicaid
IA1108894Medicaid