Provider Demographics
NPI:1063834398
Name:BOLLENBACH, CHRISTOPHER (DC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:BOLLENBACH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10006 W WESTLAKES CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-5233
Mailing Address - Country:US
Mailing Address - Phone:316-347-5900
Mailing Address - Fax:316-213-1002
Practice Address - Street 1:4605 N MAIZE RD
Practice Address - Street 2:
Practice Address - City:MAIZE
Practice Address - State:KS
Practice Address - Zip Code:67101-9514
Practice Address - Country:US
Practice Address - Phone:316-347-5900
Practice Address - Fax:316-223-1002
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013045571111N00000X
KS01-05646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor