Healthcare Provider Details

I. General information

NPI: 1437149283
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL RENZE D.C., D.I.B.C.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 E 1ST ST SUITE L
ANKENY IA
50021-2169
US

IV. Provider business mailing address

925 E 1ST ST SUITE L
ANKENY IA
50021-2169
US

V. Phone/Fax

Practice location:
  • Phone: 515-965-3844
  • Fax: 515-965-3829
Mailing address:
  • Phone: 515-965-3844
  • Fax: 515-965-3829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number06501
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number06501
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: