Provider Demographics
NPI:1902553704
Name:LAMBRIGHT, MARY
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:LAMBRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-3006
Mailing Address - Country:US
Mailing Address - Phone:414-699-9544
Mailing Address - Fax:
Practice Address - Street 1:3250 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-3006
Practice Address - Country:US
Practice Address - Phone:414-699-9544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver