Provider Demographics
NPI:1487799714
Name:LAMBOTT, WANDA (PT)
Entity type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:LAMBOTT
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 1:510 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:MT
Mailing Address - Zip Code:59644-2002
Mailing Address - Country:US
Mailing Address - Phone:406-266-9945
Mailing Address - Fax:406-266-9945
Practice Address - Street 1:510 N FRONT ST
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:MT
Practice Address - Zip Code:59644-2002
Practice Address - Country:US
Practice Address - Phone:406-266-9945
Practice Address - Fax:406-266-9945
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00007992225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist