Healthcare Provider Details

I. General information

NPI: 1528562550
Provider Name (Legal Business Name): NATHAN RICHARD LAMBERTY ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 03/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEMORIAL STADIUM DR
LINCOLN NE
68588-0031
US

IV. Provider business mailing address

1 MEMORIAL STADIUM DR
LINCOLN NE
68588-0031
US

V. Phone/Fax

Practice location:
  • Phone: 402-472-2276
  • Fax:
Mailing address:
  • Phone: 402-472-2276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number851
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: