Provider Demographics
NPI:1477176105
Name:DOLAN, RYAN (DC)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:
Last Name:DOLAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 CLINTON HWY STE 105
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-3444
Mailing Address - Country:US
Mailing Address - Phone:865-315-7479
Mailing Address - Fax:
Practice Address - Street 1:4070 ASBURY AVE STE 5
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07753-8417
Practice Address - Country:US
Practice Address - Phone:732-204-6448
Practice Address - Fax:732-284-3152
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00800400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor