Provider Demographics
NPI:1902087646
Name:LAMBERT, DEENA (PT)
Entity type:Individual
Prefix:
First Name:DEENA
Middle Name:
Last Name:LAMBERT
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 1:5620 MAHONING AVE STE C
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2333
Mailing Address - Country:US
Mailing Address - Phone:330-797-9407
Mailing Address - Fax:330-797-9474
Practice Address - Street 1:335 W MCKINLEY WAY
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-1681
Practice Address - Country:US
Practice Address - Phone:330-797-9407
Practice Address - Fax:330-797-9474
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT006611225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist