Provider Demographics
NPI:1184735821
Name:OGGER, JILL (MSPT)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:
Last Name:OGGER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MRS
Other - First Name:JILL
Other - Middle Name:OGGER
Other - Last Name:SEDMAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT, ATC
Mailing Address - Street 1:1677 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48040-2542
Mailing Address - Country:US
Mailing Address - Phone:586-255-5009
Mailing Address - Fax:
Practice Address - Street 1:1985 GRATIOT BLVD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:MI
Practice Address - Zip Code:48040-2215
Practice Address - Country:US
Practice Address - Phone:810-216-1801
Practice Address - Fax:810-216-0983
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010521225100000X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer