Individual
JASON DEAN SCHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
320 COON RAPIDS BLVD NW STE 100, COON RAPIDS, MN 55433-5640
(763) 201-8191
Mailing address
9645 GROVE CIR N STE 200, MAPLE GROVE, MN 55369-2684
(763) 201-8191
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102313
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
365408700
—
MN
Enumeration date
06/08/2006
Last updated
05/13/2021
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