Basic Information
| Provider Information | |||||||||
| NPI: | 1083784821 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAMB | ||||||||
| FirstName: | ERIN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PT, MSPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 558 BLACKSTONE ST | ||||||||
| Address2: | |||||||||
| City: | HOLLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494238856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6164052001 | ||||||||
| FaxNumber: | 6163554285 | ||||||||
| Practice Location | |||||||||
| Address1: | 11971 JAMES ST | ||||||||
| Address2: | |||||||||
| City: | HOLLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494249610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6163453778 | ||||||||
| FaxNumber: | 8556700383 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2006 | ||||||||
| LastUpdateDate: | 05/29/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5501010771 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 5501010771 | 01 | MI | STATE LICENSE NUMBER | OTHER | 650G012100 | 01 | MI | BCBSM | OTHER | 1083784821 | 01 | MI | NPI | OTHER |