Provider Demographics
NPI:1356385439
Name:SCHULTZ, PAUL D (PT)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:D
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 1:523 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-5520
Mailing Address - Country:US
Mailing Address - Phone:918-756-6060
Mailing Address - Fax:918-756-6058
Practice Address - Street 1:523 E 6TH ST
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-5520
Practice Address - Country:US
Practice Address - Phone:918-756-6060
Practice Address - Fax:918-756-6058
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT2237225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist