Healthcare Provider Details

I. General information

NPI: 1598055352
Provider Name (Legal Business Name): MELANIE ANN LAMBERT LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2011
Last Update Date: 04/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7201 GREENBORO DR
WEST MELBOURNE FL
32904-1698
US

IV. Provider business mailing address

869 STARCHER RD
GALLIPOLIS OH
45631-8578
US

V. Phone/Fax

Practice location:
  • Phone: 321-727-0990
  • Fax:
Mailing address:
  • Phone: 740-794-1851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberPTA 21980
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License NumberPTA 06997
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: