Provider Demographics
NPI:1033404546
Name:LAMBRECHT, KAYLA R (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:R
Last Name:LAMBRECHT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:R
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2111 LANDMARK CIR NW STE B
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-1967
Mailing Address - Country:US
Mailing Address - Phone:701-839-4102
Mailing Address - Fax:701-838-9603
Practice Address - Street 1:2111 LANDMARK CIR NW # B
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703
Practice Address - Country:US
Practice Address - Phone:701-839-4102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1650225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1013098797Medicare PIN