Healthcare Provider Details

I. General information

NPI: 1124459961
Provider Name (Legal Business Name): ABBY OHMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2013
Last Update Date: 12/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 S TELEGRAPH RD
MONROE MI
48161-4097
US

IV. Provider business mailing address

5235 CALYX LN
TOLEDO OH
43623-2214
US

V. Phone/Fax

Practice location:
  • Phone: 877-813-9090
  • Fax: 419-472-0812
Mailing address:
  • Phone: 877-813-9090
  • Fax: 419-472-0812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number08353
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number5502003439
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: