Provider Demographics
NPI:1891768834
Name:HERRMANN, THOMAS (PT, ATC, EDD)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:HERRMANN
Suffix:
Gender:M
Credentials:PT, ATC, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9419 KENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6811
Mailing Address - Country:US
Mailing Address - Phone:513-792-0777
Mailing Address - Fax:513-792-0061
Practice Address - Street 1:5260 CROOKSHANK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-3306
Practice Address - Country:US
Practice Address - Phone:513-792-0777
Practice Address - Fax:513-792-0061
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT8022208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH00000000178624OtherANTHEM PIN
OHCJ9603OtherRR MEDICARE GROUP
OHP50942Medicare UPIN
OHCJ9603OtherRR MEDICARE GROUP