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Individual

DR. RONALD J. PELLICANI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
568 GEORGE BISHOP PKWY, MYRTLE BEACH, SC 29579-7339
(843) 236-2200
Mailing address
4016 RIVER OAKS DR # 149, MYRTLE BEACH, SC 29579-6673
(843) 236-2200

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1610
MA
111N00000X
Chiropractor
Primary
3616
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0014298
NEIGHBORHOOD HEALTH PLAN
MA
05
1610082
MA
01
181432
AETNA
MA
01
994529
NETWORK HEALTH PLAN
MA
05
CH3616
SC
01
Y36167
BC/BS OF MA
MA
Enumeration date
09/26/2006
Last updated
02/26/2021
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