Provider Demographics
NPI:1154033876
Name:LAM, VINH (DPT)
Entity type:Individual
Prefix:DR
First Name:VINH
Middle Name:
Last Name:LAM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1849 NW 172ND ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-7011
Mailing Address - Country:US
Mailing Address - Phone:405-464-7821
Mailing Address - Fax:
Practice Address - Street 1:3705 NW 63RD ST STE 201
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1937
Practice Address - Country:US
Practice Address - Phone:405-297-4968
Practice Address - Fax:972-848-5269
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6169225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist