Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 016878 | MI |
NPI | 1003905886 |
---|---|
Provider Name | Mrs. Jean M Schultz |
First Address | Lansing, MI 48912-2383 |
Second Address | Lansing, MI 48912-2383 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |