Organization
DR. RICHARD C. REBUCK, OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD CARL REBUCK O.D. (OWNER)
(304) 263-4747
Entity
Organization
Contact information
Practice address
800 FOXCROFT AVE, STE 914, MARTINSBURG, WV 25401-1829
(304) 263-4747
(304) 263-2935
Mailing address
255 APPALOOSA DR, FALLING WATERS, WV 25419-3854
(304) 263-4747
(304) 263-2935
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
971-OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810009839
—
WV
Enumeration date
03/23/2007
Last updated
03/17/2008
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