Provider Demographics
NPI:1669688941
Name:LOHMAN, EVERETT BERNELL III (PT)
Entity Type:Individual
Prefix:PROF
First Name:EVERETT
Middle Name:BERNELL
Last Name:LOHMAN
Suffix:III
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-7345
Mailing Address - Country:US
Mailing Address - Phone:909-558-1000
Mailing Address - Fax:909-558-0459
Practice Address - Street 1:611 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-7345
Practice Address - Country:US
Practice Address - Phone:909-558-1000
Practice Address - Fax:909-558-0459
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA163772251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic