Provider Demographics
NPI:1962992842
Name:D AUSTIN REHL DDS PETER E LOVEJOY DDS AND JAREK S ATWOOD DDS, PLLC
Entity type:Organization
Organization Name:D AUSTIN REHL DDS PETER E LOVEJOY DDS AND JAREK S ATWOOD DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-374-7060
Mailing Address - Street 1:99 ROSEMAR RD
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-7657
Mailing Address - Country:US
Mailing Address - Phone:304-424-3884
Mailing Address - Fax:304-424-3973
Practice Address - Street 1:99 ROSEMAR RD
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-7657
Practice Address - Country:US
Practice Address - Phone:304-424-3884
Practice Address - Fax:304-424-3973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental