Individual
MRS. DANA YVETTE OGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
19130 SUNNY ACRES RD, PETERSBURG, IL 62675-7306
(217) 632-2334
Mailing address
19130 SUNNY ACRES RD, PETERSBURG, IL 62675-7306
(217) 632-2334
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160-002274
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160-002274
PTA LICENSE
IL
Enumeration date
10/01/2007
Last updated
10/01/2007
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