Provider Demographics
NPI:1740678218
Name:RANALLO, HARRISON (DC)
Entity type:Individual
Prefix:
First Name:HARRISON
Middle Name:
Last Name:RANALLO
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 1:17 MAIN ST STE 403
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-1436
Mailing Address - Country:US
Mailing Address - Phone:609-686-2050
Mailing Address - Fax:
Practice Address - Street 1:17 MAIN ST STE 403
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-1436
Practice Address - Country:US
Practice Address - Phone:609-686-2050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-06
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6032111N00000X
NJ38MC00737100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor