Healthcare Provider Details

I. General information

NPI: 1003859232
Provider Name (Legal Business Name): LAMBERT CHIROPRACTIC CLINIC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 NORTHLAND DR
GRAND RAPIDS MI
49525
US

IV. Provider business mailing address

5300 NORTHLAND DR
GRAND RAPIDS MI
49525
US

V. Phone/Fax

Practice location:
  • Phone: 616-361-7810
  • Fax: 616-361-0036
Mailing address:
  • Phone: 616-361-7810
  • Fax: 616-361-0036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberTL005273
License Number StateMI

VIII. Authorized Official

Name: TERRANCE M LAMBERT
Title or Position: OWNER/PRESIDENT
Credential: DC
Phone: 616-361-7810