Provider Demographics
NPI:1982345153
Name:MENTZER, COLTON MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:COLTON
Middle Name:MICHAEL
Last Name:MENTZER
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 1:608 EAST ST
Mailing Address - Street 2:
Mailing Address - City:ALDEN
Mailing Address - State:IA
Mailing Address - Zip Code:50006-9638
Mailing Address - Country:US
Mailing Address - Phone:515-689-7494
Mailing Address - Fax:
Practice Address - Street 1:2302 W 1ST ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-5106
Practice Address - Country:US
Practice Address - Phone:515-964-1969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-04
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA113246111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor