Healthcare Provider Details

I. General information

NPI: 1588723670
Provider Name (Legal Business Name): MRS. ELIZABETH JEAN HORLBOGEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 POST ROAD J ARTHUR TRUDEAU MEMORIAL CENTER ATTN KIM RUELLE
WARWICK RI
02886-7147
US

IV. Provider business mailing address

58 BATES AVE
NORTH KINGSTOWN RI
02852-6802
US

V. Phone/Fax

Practice location:
  • Phone: 401-739-2700
  • Fax: 401-737-8907
Mailing address:
  • Phone: 401-258-5035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL8320
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: