Provider Demographics
NPI:1104845031
Name:LAM-AMBLER, JENNIFER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:LAM-AMBLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:LAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:11753 W. AVENIDA DEL SOL
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85373
Mailing Address - Country:US
Mailing Address - Phone:623-444-5396
Mailing Address - Fax:
Practice Address - Street 1:8685 W UNION HILLS DR
Practice Address - Street 2:SUITE 600
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-7006
Practice Address - Country:US
Practice Address - Phone:623-486-2331
Practice Address - Fax:623-486-3136
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7294174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist