Provider Demographics
NPI:1962572594
Name:JANWAY CHIROPRACTIC, INC. P.C.
Entity type:Organization
Organization Name:JANWAY CHIROPRACTIC, INC. P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JANWAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-683-0981
Mailing Address - Street 1:PO BOX 337
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74402-0337
Mailing Address - Country:US
Mailing Address - Phone:918-683-0981
Mailing Address - Fax:918-683-0148
Practice Address - Street 1:655 E OKMULGEE ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-5529
Practice Address - Country:US
Practice Address - Phone:918-683-0981
Practice Address - Fax:918-683-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2336111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK73-1165944-003OtherBCBS
OK73-1165944-003OtherBCBS