# ZEN SPINE & SPORT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679210017
- **Authorized official:** DR. KURT WAYNE VAN VELDHUIZEN DC (OWNER)
- **Authorized official phone:** (319) 610-2539

## Contact information

- **Practice address:** 5705 NW 100TH ST STE 200, JOHNSTON, IA 50131-1858
- **Practice address phone:** (515) 776-8687
- **Mailing address:** 5705 NW 100TH ST STE 200, JOHNSTON, IA 50131-1858
- **Mailing address phone:** (515) 776-8687

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | Yes |
| 111N00000X | Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 05/17/2022
- **Last updated:** 03/06/2023