Provider Demographics
NPI:1912016965
Name:LAMBE, GREGORY ARNOLD (DC)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:ARNOLD
Last Name:LAMBE
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 1:3894 HIGHWAY 90
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446-8919
Mailing Address - Country:US
Mailing Address - Phone:850-482-2966
Mailing Address - Fax:
Practice Address - Street 1:3894 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446-8919
Practice Address - Country:US
Practice Address - Phone:850-482-2966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004466111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU08609Medicare UPIN
FL88071Medicare ID - Type Unspecified