Provider Demographics
NPI:1144333634
Name:JONES, RHONDA LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:LYNN
Last Name:JONES
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 1:11935 OLIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6729
Mailing Address - Country:US
Mailing Address - Phone:314-432-0005
Mailing Address - Fax:314-432-5899
Practice Address - Street 1:11935 OLIVE BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6729
Practice Address - Country:US
Practice Address - Phone:314-432-0005
Practice Address - Fax:314-432-5899
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005091111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO134566OtherBLUECROSSBLUESHIELD
MO113080OtherGHP
MO117393OtherHEALTH LINK
MO44-00114OtherUNITED HEALTHCARE
MO4232626OtherAETNA
MOT43479Medicare UPIN