Provider Demographics
NPI:1184705519
Name:LAMBIOTTE, THOMAS (PT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:LAMBIOTTE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 TOWNSHIP RD
Mailing Address - Street 2:369 SUITE 104
Mailing Address - City:PROCTORVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45669
Mailing Address - Country:US
Mailing Address - Phone:740-886-5555
Mailing Address - Fax:740-886-0290
Practice Address - Street 1:96 TOWNSHIP RD
Practice Address - Street 2:369 SUITE 104
Practice Address - City:PROCTORVILLE
Practice Address - State:OH
Practice Address - Zip Code:45669
Practice Address - Country:US
Practice Address - Phone:740-886-5555
Practice Address - Fax:740-886-0290
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-1007225100000X
WV001101225100000X
KYPT-002380225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0156723000Medicaid
OH000000385112OtherANTHEM BC/BS
OH2261896Medicaid
OHS75023Medicare UPIN
OH2261896Medicaid