Provider Demographics
NPI:1265024053
Name:LAMM, EDDIE (HIS)
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:
Last Name:LAMM
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1977 DEWAR DR STE E
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5757
Mailing Address - Country:US
Mailing Address - Phone:307-223-0048
Mailing Address - Fax:
Practice Address - Street 1:1977 DEWAR DR STE E
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5757
Practice Address - Country:US
Practice Address - Phone:307-223-0048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY214237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY214OtherWYOMING BOARD OF HEARING INSTRUMENT SPECIALIST