Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1050177 | TX |
NPI | 1003245549 |
---|---|
Provider Name | Paula Lambert |
First Address | Antlers, OK 74523-2087 |
Second Address | Antlers, OK 74523-2087 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2013 |
Last Update Date | 05/11/2013 |