Provider Demographics
NPI:1841333572
Name:OCKLER, THOMAS KARL (PT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:KARL
Last Name:OCKLER
Suffix:
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 1:36200 EUCLID AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4400
Mailing Address - Country:US
Mailing Address - Phone:440-918-0836
Mailing Address - Fax:440-918-0853
Practice Address - Street 1:36200 EUCLID AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4400
Practice Address - Country:US
Practice Address - Phone:440-918-0836
Practice Address - Fax:440-918-0853
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2485225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2138190Medicaid
OH2138190Medicaid