Provider Demographics
NPI:1033136122
Name:VEZENDY, JON MICHAEL (DC)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:MICHAEL
Last Name:VEZENDY
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 1:20723 TORRENCE CHAPEL RD
Mailing Address - Street 2:STE 201
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-6399
Mailing Address - Country:US
Mailing Address - Phone:704-895-2240
Mailing Address - Fax:704-765-4077
Practice Address - Street 1:20723 TORRENCE CHAPEL RD
Practice Address - Street 2:STE 201
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-6399
Practice Address - Country:US
Practice Address - Phone:704-895-2240
Practice Address - Fax:704-765-4077
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC3013111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health