Provider Demographics
NPI:1508093279
Name:LAMBERT, MELANIE DIANE (DPT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:DIANE
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:DIANE
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 S 21ST ST UNIT 130
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-3763
Mailing Address - Country:US
Mailing Address - Phone:719-634-1110
Mailing Address - Fax:719-634-1112
Practice Address - Street 1:2375 TELSTAR DR STE 115
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-1029
Practice Address - Country:US
Practice Address - Phone:719-634-1110
Practice Address - Fax:719-634-1112
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-02421225100000X
NC136652251X0800X
COPTL0019649225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic