Provider Demographics
NPI:1790714186
Name:FOX, RHONDA LEE (RD, LD)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:LEE
Last Name:FOX
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:LEE
Other - Last Name:EITNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:2655 W NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-3617
Mailing Address - Country:US
Mailing Address - Phone:937-525-3093
Mailing Address - Fax:937-505-4007
Practice Address - Street 1:2655 W NATIONAL RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-3617
Practice Address - Country:US
Practice Address - Phone:937-525-3093
Practice Address - Fax:937-505-4007
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
861152133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered