Provider Demographics
NPI:1679854186
Name:OGDEN, LYDIA (DC)
Entity Type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:
Last Name:OGDEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:453 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT ORAB
Mailing Address - State:OH
Mailing Address - Zip Code:45154-8600
Mailing Address - Country:US
Mailing Address - Phone:937-444-6000
Mailing Address - Fax:937-444-6001
Practice Address - Street 1:453 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT ORAB
Practice Address - State:OH
Practice Address - Zip Code:45154-8600
Practice Address - Country:US
Practice Address - Phone:937-444-6000
Practice Address - Fax:937-444-6001
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor