Provider Demographics
NPI:1700036571
Name:ELIZABETH J. OGDEN
Entity Type:Organization
Organization Name:ELIZABETH J. OGDEN
Other - Org Name:UPPER VALLEY PILATES AND PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:OGDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:802-299-6159
Mailing Address - Street 1:PO BOX 862
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:VT
Mailing Address - Zip Code:05055-0862
Mailing Address - Country:US
Mailing Address - Phone:802-299-6159
Mailing Address - Fax:603-643-2011
Practice Address - Street 1:316 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:VT
Practice Address - Zip Code:05055-4428
Practice Address - Country:US
Practice Address - Phone:802-299-6159
Practice Address - Fax:603-643-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0003603261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTVN2682Medicare UPIN
VTOG-VN3742Medicare PIN