MEDICARE: REBECCA ALLEN OD

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	152W00000X	Optometrist	6732	OH

General Provider Information

NPI Number	:	1528628310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA ALLEN OD

Provider Business Mailing Address
First Line	:	2920 GLENDALE MILFORD RD STE 220
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45241-4840
Country	:	US
Telephone Number	:	513-922-9000
Fax Number	:	513-922-4050

Provider Business Practice Location Address
First Line	:	2920 GLENDALE MILFORD RD STE 220
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45241-4840
Country	:	US
Telephone Number	:	513-922-9000
Fax Number	:	513-922-4050

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

Provider Enumeration Date	:	06/14/2019
Last Update Date	:	06/14/2019

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Directions to “ REBECCA ALLEN OD” Practice Location

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