MEDICARE: DR. JENNIFER ELAINE LAMB DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	5732	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AZ0244600	OTHER	AZ	BC/BS ID NUMBER

General Provider Information

NPI Number	:	1598762486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER ELAINE LAMB DC

Provider Business Mailing Address
First Line	:	21252 E NIGHTINGALE DR
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85242-6565
Country	:	US
Telephone Number	:	480-888-0255
Fax Number	:	480-926-6776

Provider Business Practice Location Address
First Line	:	201 W GUADALUPE RD
Second Line	:	STE 313
City	:	GILBERT
State	:	AZ
Zip	:	85233-3334
Country	:	US
Telephone Number	:	480-926-6900
Fax Number	:	480-926-6776

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/08/2007

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