MEDICARE: REBECCA L WOODRING 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	OEG000714	PA

General Provider Information

NPI Number	:	1841282522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA L WOODRING OD

Provider Business Mailing Address
First Line	:	736 WINTER PARK DR
Second Line	:
City	:	MARS
State	:	PA
Zip	:	16046-3950
Country	:	US
Telephone Number	:	724-772-2202
Fax Number	:

Provider Business Practice Location Address
First Line	:	187 SCHARBERRY LANE
Second Line	:
City	:	MARS
State	:	PA
Zip	:	16046-7864
Country	:	US
Telephone Number	:	724-591-5501
Fax Number	:

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	02/05/2008

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