Provider Demographics
NPI:1194880716
Name:LAMPRECHT, NICHOL PAULINE BULT (PT)
Entity type:Individual
Prefix:MS
First Name:NICHOL
Middle Name:PAULINE BULT
Last Name:LAMPRECHT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 387
Mailing Address - Street 2:
Mailing Address - City:ROLLINSVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80474-0387
Mailing Address - Country:US
Mailing Address - Phone:303-258-7558
Mailing Address - Fax:
Practice Address - Street 1:187 PATRICIA ROAD
Practice Address - Street 2:
Practice Address - City:ROLLINSVILLE
Practice Address - State:CO
Practice Address - Zip Code:80474-0387
Practice Address - Country:US
Practice Address - Phone:303-258-7558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist