Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS040594 | PA |
NPI | 1053821975 |
---|---|
Provider Name | Lindsay Rambo |
First Address | Sellersville, PA 18960-1611 |
Second Address | Lansdale, PA 19446-1055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2017 |
Last Update Date | 05/10/2017 |