Healthcare Provider Details

I. General information

NPI: 1861862856
Provider Name (Legal Business Name): BOLLENBACH CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2015
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 N MAIZE RD
MAIZE KS
67101-9514
US

IV. Provider business mailing address

4605 N MAIZE RD
MAIZE KS
67101-9514
US

V. Phone/Fax

Practice location:
  • Phone: 316-347-5900
  • Fax: 316-223-1002
Mailing address:
  • Phone: 316-347-5900
  • Fax: 316-223-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number01-05646
License Number StateKS

VIII. Authorized Official

Name: CHRISTOPHER BOLLENBACH
Title or Position: OWNER/CHIROPRACTOR/SOLE MBR
Credential: D.C.
Phone: 316-347-5900