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General NPI Number Information
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NPI Number | 1952332629
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Entity Type | Organization
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Legal Business Name | JANNING ENT CENTER, LLC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 1801 19TH AVE SW
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City | WILLMAR
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State | MN
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Zip | 56201-4946
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Country | US
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Telephone | 320-231-3277
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Fax | 320-214-5758
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Provider Business Mailing Address
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Address Line | 1801 19TH AVE SW
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City | WILLMAR
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State | MN
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Zip | 56201-4946
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Country | US
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Telephone | 320-231-3277
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Fax | 320-214-5758
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARTIN HEINZ JANNING
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Credential | M.D.
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Telephone | 320-231-3277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 40016
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License Number State | MN
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