Provider Demographics
NPI:1932283744
Name:DR. RONDA MARSHALL, D.C., L.L.C.
Entity Type:Organization
Organization Name:DR. RONDA MARSHALL, D.C., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:V
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-674-4897
Mailing Address - Street 1:3093 SASHABAW RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329-4089
Mailing Address - Country:US
Mailing Address - Phone:248-674-4897
Mailing Address - Fax:248-674-4905
Practice Address - Street 1:3093 SASHABAW RD
Practice Address - Street 2:SUITE B
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48329-4089
Practice Address - Country:US
Practice Address - Phone:248-674-4897
Practice Address - Fax:248-674-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009130111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P37040Medicare ID - Type Unspecified