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General NPI Number Information
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NPI Number | 1790541563
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Entity Type | Organization
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Legal Business Name | THE PELVIC OT LLC
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 139 GOOSE HILL RD
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City | CHESTER
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State | CT
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Zip | 06412-1227
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Country | US
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Telephone | 203-305-8596
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Fax |
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Provider Business Mailing Address
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Address Line | 139 GOOSE HILL RD
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City | CHESTER
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State | CT
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Zip | 06412-1227
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Country | US
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Telephone | 203-305-8596
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Fax |
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Authorized Official
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Title or Position | OWNER AND OCCUPATIONAL THERAPIST
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Name | DR. JAIMEE MB HEGGE
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Credential | OTD, OTR/L
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Telephone | 203-305-8596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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