Provider Demographics
NPI:1851696876
Name:DOLL, RHONDA JO (CMT)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:JO
Last Name:DOLL
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 ALLYSON AVE SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-4834
Mailing Address - Country:US
Mailing Address - Phone:616-893-7928
Mailing Address - Fax:
Practice Address - Street 1:2727 RIDGEMOOR DR SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49512-1638
Practice Address - Country:US
Practice Address - Phone:616-977-7840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-22
Last Update Date:2011-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist