Provider Demographics
NPI:1033285911
Name:LAMB, PAUL D (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:LAMB
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 1:476 ROLLING DRIVE SUITE 200
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801
Mailing Address - Country:US
Mailing Address - Phone:814-231-2101
Mailing Address - Fax:814-231-8569
Practice Address - Street 1:476 ROLLING RIDGE DRIVE SUITE 200
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801
Practice Address - Country:US
Practice Address - Phone:814-231-2101
Practice Address - Fax:814-231-8569
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007360L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU72731Medicare UPIN
PA021215KAOMedicare ID - Type UnspecifiedMEDICARE#