Provider Demographics
NPI:1548911274
Name:SCHULTZ, TIMOTHY RYAN (DC)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:RYAN
Last Name:SCHULTZ
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 1:7160 RAFAEL RIVERA WAY STE 325
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-5394
Mailing Address - Country:US
Mailing Address - Phone:702-430-8099
Mailing Address - Fax:702-926-6142
Practice Address - Street 1:7160 RAFAEL RIVERA WAY STE 325
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-5394
Practice Address - Country:US
Practice Address - Phone:702-430-8099
Practice Address - Fax:702-926-6142
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-2223111N00000X
NVB02040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor