Organization
THEOPHIL JANTZ, D.O., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEOPHIL JANTZ D.O. (OWNER)
(707) 964-6910
Entity
Organization
Contact information
Practice address
721 RIVER DR, STE B, FORT BRAGG, CA 95437
(775) 747-5050
(775) 747-5005
Mailing address
PO BOX 34120, RENO, NV 89533-4120
(775) 747-5050
(775) 747-5005
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20A9193
CA
Other
Enumeration date
05/24/2007
Last updated
08/22/2020
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