MEDICARE: MRS. REBECCA RUTH JONES OCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	405300000X	Prevention Professional	OCPC161310	OH

General Provider Information

NPI Number	:	1356850275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA RUTH JONES OCPC

Provider Business Mailing Address
First Line	:	2621 VICTORY PKWY
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1754
Country	:	US
Telephone Number	:	513-684-7966
Fax Number	:	513-684-7983

Provider Business Practice Location Address
First Line	:	1908 SEYMOUR AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-4007
Country	:	US
Telephone Number	:	513-363-1874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2017
Last Update Date	:	09/22/2017

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