Provider Demographics
NPI:1962958041
Name:MENDENHALL, JOHN II (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:MENDENHALL
Suffix:II
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 PERRY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-6691
Mailing Address - Country:US
Mailing Address - Phone:609-560-0565
Mailing Address - Fax:
Practice Address - Street 1:1107 CAPITAL BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1113
Practice Address - Country:US
Practice Address - Phone:919-795-6086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01679900225100000X
NCP21411225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist