Provider Demographics
NPI:1598762486
Name:LAMB, JENNIFER ELAINE (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ELAINE
Last Name:LAMB
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21252 E NIGHTINGALE DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85242-6565
Mailing Address - Country:US
Mailing Address - Phone:480-888-0255
Mailing Address - Fax:480-926-6776
Practice Address - Street 1:201 W GUADALUPE RD
Practice Address - Street 2:STE 313
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3334
Practice Address - Country:US
Practice Address - Phone:480-926-6900
Practice Address - Fax:480-926-6776
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5732111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0244600OtherBC/BS ID NUMBER
AZ20397Medicare ID - Type UnspecifiedINDIV. MEDICARE NUMBER
AZAZ0244600OtherBC/BS ID NUMBER