Healthcare Provider Details

I. General information

NPI: 1376888438
Provider Name (Legal Business Name): RYAN HOHMAN PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2012
Last Update Date: 11/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ADAMS AVE
PITTSBURGH PA
15243-1028
US

IV. Provider business mailing address

312 ATHENA DR
DELMONT PA
15626-1204
US

V. Phone/Fax

Practice location:
  • Phone: 412-489-3556
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTEI001450
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: