Provider Demographics
NPI:1205037173
Name:BROHM, LORI A (PT, MBA, EDM)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:A
Last Name:BROHM
Suffix:
Gender:F
Credentials:PT, MBA, EDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 THOMAS DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-2953
Mailing Address - Country:US
Mailing Address - Phone:419-289-6813
Mailing Address - Fax:
Practice Address - Street 1:2000 CENTER ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-4325
Practice Address - Country:US
Practice Address - Phone:419-289-1585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH004213225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist