Organization
ENHANCED CHIROPRACTIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN RYAN KOLONICH DC (DOCTOR)
(609) 714-1107
Entity
Organization
Contact information
Practice address
30 JACKSON RD, SUITE A1, MEDFORD, NJ 08055-9283
(609) 714-1107
Mailing address
30 JACKSON RD, SUITE A1, MEDFORD, NJ 08055-9283
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00633400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119956
MEDICARE GROUP
NJ
01
—
1730362591
NPI
NJ
01
—
2765346000
PERSONAL CHOICE
NJ
Enumeration date
12/14/2007
Last updated
07/16/2008
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