Individual
DR. VINCENT VENEZIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2365 WALL ST SE, SUITE 100, CONYERS, GA 30013-2197
(678) 602-2569
(770) 922-9107
Mailing address
741 LYNN MILAM LN, CONYERS, GA 30094-4108
(678) 602-2569
(770) 922-9107
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
5106
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00923865A
—
GA
Enumeration date
01/20/2012
Last updated
01/20/2012
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