Provider Demographics
NPI:1922846013
Name:STELCK, RHONDA (LAC)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:STELCK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 263
Mailing Address - Street 2:
Mailing Address - City:VERDI
Mailing Address - State:NV
Mailing Address - Zip Code:89439-0263
Mailing Address - Country:US
Mailing Address - Phone:760-420-4402
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 263
Practice Address - Street 2:
Practice Address - City:VERDI
Practice Address - State:NV
Practice Address - Zip Code:89439-0263
Practice Address - Country:US
Practice Address - Phone:760-420-4402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20122171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist