Provider Demographics
NPI:1992870307
Name:SCHULTZ, WILLIAM BILL (PT)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BILL
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 WALL AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-7621
Mailing Address - Country:US
Mailing Address - Phone:505-523-7243
Mailing Address - Fax:505-523-7254
Practice Address - Street 1:850 N TELSHOR BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8253
Practice Address - Country:US
Practice Address - Phone:575-650-3238
Practice Address - Fax:575-650-3238
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1449174400000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1449OtherPHYSICAL THERAPIST