Healthcare Provider Details

I. General information

NPI: 1538084579
Provider Name (Legal Business Name): BREANNE MARIE GAHM PT, DPT, DS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRE GAHM

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 STAR DRIVE
CHILLICOTHEE OH
45601-9584
US

IV. Provider business mailing address

701 OAK DR
WASHINGTON COURT HOUSE OH
43160-1831
US

V. Phone/Fax

Practice location:
  • Phone: 740-253-8098
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT021971
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: