Provider Demographics
NPI:1720143423
Name:ROTONDI, JOHN
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:ROTONDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 PINE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-3220
Mailing Address - Country:US
Mailing Address - Phone:864-434-2529
Mailing Address - Fax:
Practice Address - Street 1:1200 WOODRUFF RD
Practice Address - Street 2:STE A-9
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5730
Practice Address - Country:US
Practice Address - Phone:864-434-2529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-25
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2477111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor