Basic Information
Provider Information
NPI: 1578614442
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHULTZ SOLTYSIK
FirstName: KAREN
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4583 S WILDFLOWER PL
Address2:  
City: CHANDLER
State: AZ
PostalCode: 852484863
CountryCode: US
TelephoneNumber: 4808211977
FaxNumber: 4808211887
Practice Location
Address1: 1076 W CHANDLER BLVD
Address2: STE 103
City: CHANDLER
State: AZ
PostalCode: 852245225
CountryCode: US
TelephoneNumber: 4808211997
FaxNumber: 4808211887
Other Information
ProviderEnumerationDate: 01/16/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000X7567AZY193200000X MULTI-SPECIALTY GROUPOther Service ProvidersSpecialist 

No ID Information.


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