Individual
MRS. REBECCA V ST JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4030 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1510
(304) 766-2220
(304) 766-0824
Mailing address
4030 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1510
(304) 766-2220
(304) 766-0824
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
989OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132743
CARELINK
—
01
—
7230192
AETNA
—
Enumeration date
09/16/2005
Last updated
04/04/2008
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