Provider Demographics
NPI:1376706564
Name:LAMB, CARRIE ANN (PT)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:LAMB
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7456
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-0456
Mailing Address - Country:US
Mailing Address - Phone:720-347-8626
Mailing Address - Fax:
Practice Address - Street 1:6110 E COLFAX AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1566
Practice Address - Country:US
Practice Address - Phone:303-304-6002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86122251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0259744OtherWASHINGTON L&I
OR242416Medicaid
COCOA105721Medicare PIN