Individual
DR. GERARD A. JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., L.AC.
Contact information
Practice address
402 N RILEY ST, KENDALLVILLE, IN 46755-1262
(260) 347-1150
(260) 347-1155
Mailing address
402 N RILEY ST, KENDALLVILLE, IN 46755-1262
(260) 347-1150
(260) 347-1155
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08000718
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000184397
ANTHEM/BCBS
IN
05
—
100189090A
—
IN
01
—
350011194
RAILROAD MEDICARE
IN
Enumeration date
04/24/2006
Last updated
09/23/2010
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