Provider Demographics
NPI:1790541563
Name:THE PELVIC OT LLC
Entity Type:Organization
Organization Name:THE PELVIC OT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND OCCUPATIONAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIMEE
Authorized Official - Middle Name:MB
Authorized Official - Last Name:HEGGE
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:203-305-8596
Mailing Address - Street 1:139 GOOSE HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06412-1227
Mailing Address - Country:US
Mailing Address - Phone:203-305-8596
Mailing Address - Fax:
Practice Address - Street 1:139 GOOSE HILL RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:CT
Practice Address - Zip Code:06412-1227
Practice Address - Country:US
Practice Address - Phone:203-305-8596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health