Healthcare Provider Details

I. General information

NPI: 1891652152
Provider Name (Legal Business Name): CARLY DEE JANSON DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 W MAIN ST
DUNCAN OK
73533-4616
US

IV. Provider business mailing address

285853 E 1800 RD
COMANCHE OK
73529-4670
US

V. Phone/Fax

Practice location:
  • Phone: 580-252-1064
  • Fax: 580-252-1253
Mailing address:
  • Phone: 580-252-1064
  • Fax: 580-252-1253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number4659
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: