Provider Demographics
NPI:1487724951
Name:SCHULTZ, ALAN J (D,C)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:J
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:D,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 NW 62ND AVE
Mailing Address - Street 2:BOX 708
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1537
Mailing Address - Country:US
Mailing Address - Phone:515-270-2924
Mailing Address - Fax:
Practice Address - Street 1:5850 NW 62 AVE
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-0708
Practice Address - Country:US
Practice Address - Phone:515-270-2924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2012-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA5344111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
28967Medicare UPIN