Provider Demographics
NPI:1871302299
Name:SCHULTZ, JACOB J (CHW)
Entity type:Individual
Prefix:MR
First Name:JACOB
Middle Name:J
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 HOYT AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1714
Mailing Address - Country:US
Mailing Address - Phone:989-753-9011
Mailing Address - Fax:
Practice Address - Street 1:732 HOYT AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48607-1714
Practice Address - Country:US
Practice Address - Phone:989-753-9011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker