Provider Demographics
NPI:1720795834
Name:LAMBERT, ADRIA LENORE (LAC)
Entity Type:Individual
Prefix:
First Name:ADRIA
Middle Name:LENORE
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3677 E MILKHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-7504
Mailing Address - Country:US
Mailing Address - Phone:317-654-2964
Mailing Address - Fax:
Practice Address - Street 1:25 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-1661
Practice Address - Country:US
Practice Address - Phone:317-210-0039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN84000239A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist