Healthcare Provider Details

I. General information

NPI: 1164986147
Provider Name (Legal Business Name): VEZENDY CHIROPRACTIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2019
Last Update Date: 01/24/2023
Certification Date: 01/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20723 TORRENCE CHAPEL RD STE 201
CORNELIUS NC
28031-6399
US

IV. Provider business mailing address

20723 TORRENCE CHAPEL RD STE 201
CORNELIUS NC
28031-6399
US

V. Phone/Fax

Practice location:
  • Phone: 704-895-2240
  • Fax:
Mailing address:
  • Phone: 704-895-2240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0100X
TaxonomyOccupational Health Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JON VEZENDY
Title or Position: PRESIDENT
Credential: DC
Phone: 704-252-1093