Provider Demographics
NPI:1184667131
Name:LAMBERT, MELANIE BECKHAM (MSR, PT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:BECKHAM
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:MSR, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:ST MATTHEWS
Mailing Address - State:SC
Mailing Address - Zip Code:29135-1467
Mailing Address - Country:US
Mailing Address - Phone:803-776-3109
Mailing Address - Fax:
Practice Address - Street 1:14 PALATINE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-2246
Practice Address - Country:US
Practice Address - Phone:803-776-3109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42452251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics