Provider Demographics
NPI:1639444300
Name:LAMP, STUART CHARLES (DC)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:CHARLES
Last Name:LAMP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4554 38TH AVE S STE E
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8515
Mailing Address - Country:US
Mailing Address - Phone:701-277-3081
Mailing Address - Fax:701-277-3052
Practice Address - Street 1:4554 38TH AVE S STE E
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-8515
Practice Address - Country:US
Practice Address - Phone:701-277-3081
Practice Address - Fax:701-277-3052
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-14
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND907111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation