Provider Demographics
NPI:1104038785
Name:LAM, CAREY ELIZABETH (MPT)
Entity Type:Individual
Prefix:MRS
First Name:CAREY
Middle Name:ELIZABETH
Last Name:LAM
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 SHADOW MOUNTAIN TRL
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-5932
Mailing Address - Country:US
Mailing Address - Phone:307-634-2936
Mailing Address - Fax:
Practice Address - Street 1:3718 PIONEER AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-1246
Practice Address - Country:US
Practice Address - Phone:307-421-5554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT-1086225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist