Provider Demographics
NPI:1043374374
Name:LAMB, HEATH ALLEN (MS, ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:HEATH
Middle Name:ALLEN
Last Name:LAMB
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 YATES ST
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-4152
Mailing Address - Country:US
Mailing Address - Phone:870-897-9530
Mailing Address - Fax:
Practice Address - Street 1:123 YATES ST
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-4152
Practice Address - Country:US
Practice Address - Phone:870-897-9530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAT3742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer