Provider Demographics
NPI:1255846572
Name:RHONDA SHELL LLC
Entity Type:Organization
Organization Name:RHONDA SHELL LLC
Other - Org Name:BACK ON TRACK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:OSBON
Authorized Official - Last Name:SHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-968-2225
Mailing Address - Street 1:27250 PERDIDO BEACH BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:ORANGE BEACH
Mailing Address - State:AL
Mailing Address - Zip Code:36561-3205
Mailing Address - Country:US
Mailing Address - Phone:251-968-2225
Mailing Address - Fax:251-981-7600
Practice Address - Street 1:27250 PERDIDO BEACH BLVD STE A
Practice Address - Street 2:
Practice Address - City:ORANGE BEACH
Practice Address - State:AL
Practice Address - Zip Code:36561-3205
Practice Address - Country:US
Practice Address - Phone:251-968-2225
Practice Address - Fax:251-981-7600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-08
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty