Provider Demographics
NPI:1336314905
Name:RI-JAC,INC.
Entity Type:Organization
Organization Name:RI-JAC,INC.
Other - Org Name:PLEASANT PLAINS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:L
Authorized Official - Last Name:VUYOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-341-5252
Mailing Address - Street 1:1333 ROUTE 9
Mailing Address - Street 2:STE1
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-4074
Mailing Address - Country:US
Mailing Address - Phone:732-341-5252
Mailing Address - Fax:732-341-6575
Practice Address - Street 1:1333 ROUTE 9
Practice Address - Street 2:STE1
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-4074
Practice Address - Country:US
Practice Address - Phone:732-341-5252
Practice Address - Fax:732-341-6575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00445100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU49372Medicare UPIN