Revitalize Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

REVITALIZE CHIROPRACTIC, LLC

Practice address

4575 23Rd Ave S Ste 1100
Fargo, ND 58104-9052

Phone

(701) 532-1672

NPI assigned

Nov 19, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Garrett Keith Schultz, DCNPI 1750845988

Title

Chiropractor/Owner

Phone

(701) 532-1672

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Garrett Schultz, DC

  • Chiropractor
  • Fargo, ND
  • NPI 1750845988
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1891452371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26748 130TH AVE N",
            "city": "ULEN",
            "state": "MN",
            "postal_code": "565859629",
            "telephone_number": "701-212-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 23RD AVE S STE 1100",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581049052",
            "telephone_number": "701-532-1672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-19",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "701-532-1672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Kay Retterath
• Sandra W Retzlaff, LRD
• Angela Reule, RD
• Patric A Reuter, CRNA
• Olivia Revels-Strother
• Reviv PLLC
• Paul B Revland, PHD
• Joey Lee Rexine, MD
• Michelle Jill Rexine
• Norberto Reyes Olsson, LCSW

• Chiropractor in Fargo, ND
• Providers in Fargo, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.