Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 23988 | CA |
N | 2251N0400X | Physical Therapist - Neurology | 23988 | CA |
Y | 2251P0200X | Physical Therapist - Pediatrics | 23988 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | 23988 | CA |
NPI | 1184677544 |
---|---|
Provider Name | Mrs. Amber Marie Lancaster |
First Address | Castle Rock, CO 80104-2335 |
Second Address | Castle Rock, CO 80104-2335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 06/01/2015 |