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Individual
DR. RUSSELL THOMAS JANSSEN
Active
Individual
DR. RUSSELL THOMAS JANSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0004460
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350005997
RR MEDICARE
FL
05
—
381371100
—
FL
01
—
T54967
UPIN
FL
Enumeration date
11/15/2007
Last updated
04/28/2008
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