Individual
MICHAEL DALE SHOULTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2622 HOARD ST, MADISON, WI 53704-4827
(608) 345-8277
Mailing address
314 N LINCOLNWAY, NORTH AURORA, IL 60542-1132
(608) 345-8277
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
137960
WI
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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