Provider Demographics
NPI:1376834978
Name:BOLZ, ANNA B (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:B
Last Name:BOLZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4990 SW 21ST ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3980
Mailing Address - Country:US
Mailing Address - Phone:785-272-2090
Mailing Address - Fax:785-272-2671
Practice Address - Street 1:4990 SW 21ST ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3980
Practice Address - Country:US
Practice Address - Phone:785-272-2090
Practice Address - Fax:785-272-2671
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-29
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor