Healthcare Provider Details

I. General information

NPI: 1598945990
Provider Name (Legal Business Name): CARA LYNN OGREN P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 09/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4510 COLLINS BLVD SUITE 4
ASHTABULA OH
44004-6954
US

IV. Provider business mailing address

4510 COLLINS BLVD SUITE 4
ASHTABULA OH
44004-6954
US

V. Phone/Fax

Practice location:
  • Phone: 440-997-0014
  • Fax: 440-998-7032
Mailing address:
  • Phone: 440-997-0014
  • Fax: 440-998-7032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number9731
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: