Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 06501 | IA |
N | 111NN0400X | Neurology | 06501 | IA |
NPI | 1437149283 |
---|---|
Provider Name | Dr. Christopher Michael Renze |
First Address | Ankeny, IA 50021-2169 |
Second Address | Ankeny, IA 50021-2169 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 02/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1267773 | (05) | IA |
U89995 | (02) | IA |