Healthcare Provider Details

I. General information

NPI: 1922350180
Provider Name (Legal Business Name): MCKENZE MAIERS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MCKENZE SCHULTZ

II. Dates (important events)

Enumeration Date: 10/11/2012
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 SW TRADITION DR STE 290
ANKENY IA
50023
US

IV. Provider business mailing address

7147 VISTA DR STE 150
WEST DES MOINES IA
50266-9313
US

V. Phone/Fax

Practice location:
  • Phone: 515-875-9706
  • Fax: 515-875-9718
Mailing address:
  • Phone: 515-875-9925
  • Fax: 515-875-9923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number8461
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number080936
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: