Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 5575 T2489 | OH |
NPI | 1003909094 |
---|---|
Provider Name | Dr. Chad Aaron Shultz |
First Address | Youngstown, OH 44502-1818 |
Second Address | Youngstown, OH 44502-1818 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 09/02/2016 |