Individual
IAN REBROOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1508 SUMMIT DR W, CHARLESTON, WV 25302-2932
(304) 542-5212
Mailing address
1508 SUMMIT DR W, CHARLESTON, WV 25302-2932
(304) 542-5212
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002388
WV
Other
Enumeration date
05/17/2022
Last updated
05/17/2022
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