MEDICARE: MS. HATTIE LOUISE OHM P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT-11262	OH
2	2255A2300X	Athletic Trainer	AT-002406	OH

General Provider Information

NPI Number	:	1992793426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HATTIE LOUISE OHM P.T.

Provider Business Mailing Address
First Line	:	2164 OAKDALE RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-2852
Country	:	US
Telephone Number	:	216-371-5107
Fax Number	:

Provider Business Practice Location Address
First Line	:	14100 CEDAR RD
Second Line	:	SUITE 150
City	:	CLEVELAND
State	:	OH
Zip	:	44121-3212
Country	:	US
Telephone Number	:	216-691-9602
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	09/11/2025

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