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General NPI Number Information
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NPI Number | 1124072731
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Entity Type | Individual
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Provider Name | MATTHEW I JANZEN D.C.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 5824 NW 135TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73142-5938
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Country | US
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Telephone | 408-379-0133
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Fax |
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Provider Business Mailing Address
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Address Line | 5824 NW 135TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73142-5938
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Country | US
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Telephone | 408-379-0133
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Fax | 408-379-3931
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC24146
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License Number State | CA
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