Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 008322 | OH |
NPI | 1003236944 |
---|---|
Provider Name | Thomas Omaille |
First Address | Euclid, OH 44119-1078 |
Second Address | Euclid, OH 44119 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2014 |
Last Update Date | 18/04/2014 |