Provider Demographics
NPI:1467491209
Name:KAZONIS, JOHN EMMANUEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EMMANUEL
Last Name:KAZONIS
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 1:4004 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-1773
Mailing Address - Country:US
Mailing Address - Phone:219-465-1140
Mailing Address - Fax:219-465-0903
Practice Address - Street 1:4004 CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-1773
Practice Address - Country:US
Practice Address - Phone:219-465-1140
Practice Address - Fax:219-465-0903
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000833A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor