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Individual

MS. BARBARA JEAN GAMBLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
401 KENDALL DR, LAMAR, CO 81052-3942
(719) 336-6750
(719) 336-8368
Mailing address
401 KENDALL DR, LAMAR, CO 81052-3942
(719) 336-6750
(719) 336-8368

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
414607
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
840584583
TAX IDENTIFICATION NUMBER
CO
Enumeration date
02/14/2012
Last updated
02/14/2012
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