Provider Demographics
NPI:1114127180
Name:STANLEY, RHONDA KAY (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:KAY
Last Name:STANLEY
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
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 3662
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-6662
Mailing Address - Country:US
Mailing Address - Phone:505-425-9391
Mailing Address - Fax:
Practice Address - Street 1:2301 COLLINS DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4826
Practice Address - Country:US
Practice Address - Phone:915-373-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3374225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist