Healthcare Provider Details

I. General information

NPI: 1487900783
Provider Name (Legal Business Name): GREGORY A. LAMBE, D.C., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2012
Last Update Date: 07/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3894 HIGHWAY 90
MARIANNA FL
32446-8919
US

IV. Provider business mailing address

3894 HIGHWAY 90
MARIANNA FL
32446-8919
US

V. Phone/Fax

Practice location:
  • Phone: 850-482-2966
  • Fax: 850-526-2994
Mailing address:
  • Phone: 850-482-2966
  • Fax: 850-526-2994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberCH0004466
License Number StateFL

VIII. Authorized Official

Name: DR. GREGORY A. LAMBE
Title or Position: PRESIDENT
Credential: DC
Phone: 850-482-2966