Provider Demographics
NPI:1417263088
Name:DELREAL, RHONDA JOANN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:JOANN
Last Name:DELREAL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:JOANN
Other - Last Name:RAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:809 S CHUGACH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-6605
Mailing Address - Country:US
Mailing Address - Phone:907-746-4373
Mailing Address - Fax:907-746-4376
Practice Address - Street 1:809 S CHUGACH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-6605
Practice Address - Country:US
Practice Address - Phone:907-746-4373
Practice Address - Fax:907-746-4376
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK409225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist