Provider Demographics
NPI:1891306361
Name:LAMB, ERIN (PTA)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:LAMB
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 N ACADEMY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5337
Mailing Address - Country:US
Mailing Address - Phone:719-425-7771
Mailing Address - Fax:719-208-7730
Practice Address - Street 1:2790 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5337
Practice Address - Country:US
Practice Address - Phone:719-425-7771
Practice Address - Fax:719-208-7730
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013204225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist