Dana Yvette Ogle, PTA

Individual provider Active NPI Physical Therapy Assistant · Petersburg, IL

NPI 1801083167 · NPPES record last updated Oct 1, 2007

Key facts

NPI
1801083167
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
160-002274 (IL)
Practice address
19130 Sunny Acres Rd
Petersburg, IL 62675-7306
Phone
(217) 632-2334
NPI assigned
Oct 1, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
160-002274ILMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160-002274 IL Yes

Addresses

Primary practice location

19130 Sunny Acres Rd
Petersburg, IL 62675-7306

Mailing address

19130 Sunny Acres Rd
Petersburg, IL 62675-7306
Phone (217) 632-2334

Other identifiers

IdentifierTypeStateIssuer
160-002274OtherILPTA LICENSE

Other names

  • Mrs. Dana Yvette Marlow Former name

Other providers in Petersburg, IL

All providers in Petersburg, IL · Physical Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.