Provider Demographics
NPI:1144514712
Name:SHTULMAN FAMILY CHIROPRACTIC, PA
Entity type:Organization
Organization Name:SHTULMAN FAMILY CHIROPRACTIC, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SHTULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-275-2525
Mailing Address - Street 1:8855 HYPOLUXO RD
Mailing Address - Street 2:SUITE C-11
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-5250
Mailing Address - Country:US
Mailing Address - Phone:561-275-2525
Mailing Address - Fax:
Practice Address - Street 1:8855 HYPOLUXO RD
Practice Address - Street 2:SUITE C-11
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-5250
Practice Address - Country:US
Practice Address - Phone:561-275-2525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty