Provider Demographics
NPI:1770864050
Name:JANNING, CHRISTOPHER JOSEPH (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:JOSEPH
Last Name:JANNING
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:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IA
Mailing Address - Zip Code:50109-0160
Mailing Address - Country:US
Mailing Address - Phone:515-999-8016
Mailing Address - Fax:515-999-8017
Practice Address - Street 1:2208 BROADWAY STREET
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IA
Practice Address - Zip Code:50109-4400
Practice Address - Country:US
Practice Address - Phone:515-999-8016
Practice Address - Fax:515-999-8017
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007438111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor