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General NPI Number Information
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NPI Number | 1588371033
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Entity Type | Individual
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Provider Name | KARLIE MICHAEL LAMBERT PTA
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Gender | Female
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Dates
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Enumeration Date | 11/03/2022
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 402 NELSON BLVD
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City | KINGSTREE
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State | SC
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Zip | 29556-4058
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Country | US
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Telephone | 843-355-2288
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Fax |
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Provider Business Mailing Address
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Address Line | 1241 FRANCIS MARION DR
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City | GEORGETOWN
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State | SC
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Zip | 29440-6972
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Country | US
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Telephone | 843-325-7189
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 4929
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License Number State | SC
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