Healthcare Provider Details

I. General information

NPI: 1184667131
Provider Name (Legal Business Name): MELANIE BECKHAM LAMBERT MSR, P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 PALATINE RD
COLUMBIA SC
29209-2246
US

IV. Provider business mailing address

3006 BRIDGE ST
ST MATTHEWS SC
29135-1467
US

V. Phone/Fax

Practice location:
  • Phone: 803-776-3109
  • Fax:
Mailing address:
  • Phone: 803-776-3109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number4245
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: