Healthcare Provider Details

I. General information

NPI: 1851453138
Provider Name (Legal Business Name): JOHN D. KRISCIUNAS JR. D.C., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 02/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 ROUTE 168 SUITE 104
TURNERSVILLE NJ
08012-3215
US

IV. Provider business mailing address

860 ROUTE 168 SUITE 104
TURNERSVILLE NJ
08012-3215
US

V. Phone/Fax

Practice location:
  • Phone: 856-401-9550
  • Fax: 856-401-9551
Mailing address:
  • Phone: 856-401-9550
  • Fax: 856-401-9551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number38MC00486700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00486700
License Number StateNJ

VIII. Authorized Official

Name: DR. JOHN DANIEL KRISCIUNAS JR.
Title or Position: PRESIDENT
Credential: D.C.
Phone: 856-401-9550