Provider Demographics
NPI:1962223248
Name:WENTZKY, JOHN DARIN (HD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DARIN
Last Name:WENTZKY
Suffix:
Gender:M
Credentials:HD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 WENTZKY CIR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1017
Mailing Address - Country:US
Mailing Address - Phone:864-225-3200
Mailing Address - Fax:
Practice Address - Street 1:125 WENTZKY CIR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1017
Practice Address - Country:US
Practice Address - Phone:864-225-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator