Provider Demographics
NPI:1609818350
Name:LAMB, JAMES THEODORE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:THEODORE
Last Name:LAMB
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:259 MINISTER BROOK RD
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05682-9736
Mailing Address - Country:US
Mailing Address - Phone:802-229-1891
Mailing Address - Fax:802-262-1505
Practice Address - Street 1:81 RIVER ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3792
Practice Address - Country:US
Practice Address - Phone:802-262-1500
Practice Address - Fax:802-262-1505
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VT0400003468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTD0068367OtherBCBS
VT1011045Medicaid
LAVN3599Medicare ID - Type Unspecified