Healthcare Provider Details

I. General information

NPI: 1609707595
Provider Name (Legal Business Name): ALEX PUDENZ DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 STEEL ST
GILBERT IA
50105-2200
US

IV. Provider business mailing address

102 STEEL ST
GILBERT IA
50105-2200
US

V. Phone/Fax

Practice location:
  • Phone: 515-231-2881
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number136277
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: