Provider Demographics
NPI:1891274007
Name:TRUMAN, REBECA A
Entity Type:Individual
Prefix:
First Name:REBECA
Middle Name:A
Last Name:TRUMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 N MAIN ST STE 1B
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-1181
Mailing Address - Country:US
Mailing Address - Phone:937-561-0832
Mailing Address - Fax:
Practice Address - Street 1:232 N MAIN ST STE 1B
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-1181
Practice Address - Country:US
Practice Address - Phone:937-561-0832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65.000355171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist