Provider Demographics
NPI:1023101425
Name:LAHMERS, JILL RENEE (ATC)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:RENEE
Last Name:LAHMERS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:RENEE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:7109 BACHMAN RD
Mailing Address - Street 2:
Mailing Address - City:SARDINIA
Mailing Address - State:OH
Mailing Address - Zip Code:45171-8242
Mailing Address - Country:US
Mailing Address - Phone:937-446-3500
Mailing Address - Fax:937-446-3559
Practice Address - Street 1:7109 BACHMAN RD
Practice Address - Street 2:
Practice Address - City:SARDINIA
Practice Address - State:OH
Practice Address - Zip Code:45171-8242
Practice Address - Country:US
Practice Address - Phone:937-446-3500
Practice Address - Fax:937-446-3559
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0027362255A2300X
OHPTA.08291225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0225920002Medicare NSC