Provider Demographics
NPI:1316011596
Name:JANZEN, MELISSA J (DC)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:J
Last Name:JANZEN
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 1:4731 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
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor