Provider Demographics
NPI:1871668202
Name:DALTON, RONDA L (DC)
Entity type:Individual
Prefix:DR
First Name:RONDA
Middle Name:L
Last Name:DALTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 CHEROKEE AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3307
Mailing Address - Country:US
Mailing Address - Phone:248-798-7350
Mailing Address - Fax:
Practice Address - Street 1:135 S LIVERNOIS RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-1837
Practice Address - Country:US
Practice Address - Phone:248-798-7350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008150111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition