MEDICARE: MR. JAMES THEODORE LAMB PHYSICAL THERAPIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	0400003468	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D0068367	OTHER	VT	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609818350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES THEODORE LAMB PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	259 MINISTER BROOK RD
Second Line	:
City	:	WORCESTER
State	:	VT
Zip	:	05682-9736
Country	:	US
Telephone Number	:	802-229-1891
Fax Number	:	802-262-1505

Provider Business Practice Location Address
First Line	:	81 RIVER ST
Second Line	:	SUITE 201
City	:	MONTPELIER
State	:	VT
Zip	:	05602-3792
Country	:	US
Telephone Number	:	802-262-1500
Fax Number	:	802-262-1505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	08/09/2016

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