Healthcare Provider Details

I. General information

NPI: 1619153400
Provider Name (Legal Business Name): JANINE L OMAN PT/ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2008
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 IRVING SCHOTTENSTEIN DRIVE, WHAC
COLUMBUS OH
43210
US

IV. Provider business mailing address

535 IRVING SCHOTTENSTEIN DRIVE, WHAC
COLUMBUS OH
43210
US

V. Phone/Fax

Practice location:
  • Phone: 614-247-7678
  • Fax: 614-292-3258
Mailing address:
  • Phone: 614-247-7678
  • Fax: 614-292-3258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number3910
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number1109
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: