Provider Demographics
NPI:1285831040
Name:JANZEN CHIROPRACTIC PA
Entity Type:Organization
Organization Name:JANZEN CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DC
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:JANZEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:218-525-6060
Mailing Address - Street 1:4731 E SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55804
Mailing Address - Country:US
Mailing Address - Phone:218-525-6060
Mailing Address - Fax:218-525-6060
Practice Address - Street 1:4731 E SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55804
Practice Address - Country:US
Practice Address - Phone:218-525-6060
Practice Address - Fax:218-525-6060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty