Provider Demographics
NPI:1760559439
Name:OGDEN, ELIZABETH J (PT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:J
Last Name:OGDEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-0003603225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOG-VN3742Medicare PIN
VTVN2682Medicare UPIN