Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Omar Tatum

Individual provider Physical Therapy Assistant · NPI 1114177623

Mr. Omar Tatum is a Physical Therapy Assistant in Milwaukee, Wisconsin. Practices as a sole proprietor. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2008

Practice location Address checks out

1435 W Brown St Apt 3
Milwaukee, WI 53205-1227
Phone: (414) 418-8608
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 1198-19 (WI)

Record details

NPI number1114177623
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 22, 2008
Last updated in NPPESSeptember 22, 2008

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