Provider Demographics
NPI:1487719621
Name:LAMB, JEANNE (NMT)
Entity type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:
Last Name:LAMB
Suffix:
Gender:F
Credentials:NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 S AVENUE F
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74021-3649
Mailing Address - Country:US
Mailing Address - Phone:918-853-8775
Mailing Address - Fax:
Practice Address - Street 1:352 S AVENUE F
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:OK
Practice Address - Zip Code:74021-3649
Practice Address - Country:US
Practice Address - Phone:918-853-8775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2013-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist