Provider Demographics
NPI:1376706564
Name:LAMB, CARRIE ANN (PT)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:LAMB
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 CORPORATE CIR STE M
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5628
Mailing Address - Country:US
Mailing Address - Phone:303-993-2237
Mailing Address - Fax:
Practice Address - Street 1:420 CORPORATE CIR STE M
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5628
Practice Address - Country:US
Practice Address - Phone:303-993-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2024-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO86122251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0259744OtherWASHINGTON L&I
OR242416Medicaid
COCOA105721Medicare PIN