Provider Demographics
NPI:1598055352
Name:LAMBERT, MELANIE ANN (LPTA)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:ANN
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:869 STARCHER RD
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-8578
Mailing Address - Country:US
Mailing Address - Phone:740-794-1851
Mailing Address - Fax:
Practice Address - Street 1:7201 GREENBORO DR
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-1698
Practice Address - Country:US
Practice Address - Phone:321-727-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 21980171W00000X
OHPTA 06997171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor