Provider Demographics
NPI:1891127452
Name:LOMBARD, CRAIG S (CP/L(TN))
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:S
Last Name:LOMBARD
Suffix:
Gender:M
Credentials:CP/L(TN)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 PARK AVE NW
Mailing Address - Street 2:PO BOX 375
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-1923
Mailing Address - Country:US
Mailing Address - Phone:246-679-1188
Mailing Address - Fax:276-679-1189
Practice Address - Street 1:750 PARK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1923
Practice Address - Country:US
Practice Address - Phone:246-679-1188
Practice Address - Fax:276-679-1189
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPR192224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist