Provider Demographics
NPI:1518089879
Name:LAMBERT, CONNIE (PHD, PT)
Entity Type:Individual
Prefix:DR
First Name:CONNIE
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:PHD, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6577 BUCKNER ST
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-9072
Mailing Address - Country:US
Mailing Address - Phone:614-833-6923
Mailing Address - Fax:614-833-1204
Practice Address - Street 1:565 CHILDRENS DR W
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2648
Practice Address - Country:US
Practice Address - Phone:614-228-5523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3680225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist