Provider Demographics
NPI:1952035768
Name:VEST, JON (CPRS)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:VEST
Suffix:
Gender:M
Credentials:CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2181 CHESTNUT RD
Mailing Address - Street 2:
Mailing Address - City:SEVEN HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-3506
Mailing Address - Country:US
Mailing Address - Phone:216-278-4346
Mailing Address - Fax:
Practice Address - Street 1:18100 JEFFERSON PARK RD STE 101
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-8458
Practice Address - Country:US
Practice Address - Phone:440-403-9351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-16
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.003369175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist