Provider Demographics
NPI:1457790412
Name:JANSSEN, ANTHONY ARTHUR (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:ARTHUR
Last Name:JANSSEN
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 1:18567 E AUBREY GLEN RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-3652
Mailing Address - Country:US
Mailing Address - Phone:715-271-8166
Mailing Address - Fax:
Practice Address - Street 1:20261 E OCOTILLO RD
Practice Address - Street 2:114
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-8806
Practice Address - Country:US
Practice Address - Phone:480-987-0899
Practice Address - Fax:480-987-0922
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-22
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor