Provider Demographics
NPI:1194909283
Name:EMERSON, RHONDA LOU (DC)
Entity type:Individual
Prefix:MISS
First Name:RHONDA
Middle Name:LOU
Last Name:EMERSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:1213 MAIN STREET
Mailing Address - City:DRESDEN
Mailing Address - State:OH
Mailing Address - Zip Code:43821
Mailing Address - Country:US
Mailing Address - Phone:740-754-3339
Mailing Address - Fax:
Practice Address - Street 1:1213 MAIN STREET
Practice Address - Street 2:
Practice Address - City:DRESDEN
Practice Address - State:OH
Practice Address - Zip Code:43821
Practice Address - Country:US
Practice Address - Phone:740-754-3339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1558111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU16724Medicare UPIN
OH0668472Medicare PIN