Provider Demographics
NPI:1891857710
Name:JANTZ, CARL C JR (DC)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:C
Last Name:JANTZ
Suffix:JR
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 1:428 DUTCH NECK RD
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1202
Mailing Address - Country:US
Mailing Address - Phone:609-448-6648
Mailing Address - Fax:
Practice Address - Street 1:428 DUTCH NECK RD
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1202
Practice Address - Country:US
Practice Address - Phone:609-448-6648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00120300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ000140693Medicare ID - Type Unspecified