Individual
MR. JUSTUS FLIN LAMBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1595 YELLOWSTONE AVE, POCATELLO, ID 83201-4203
(208) 233-0032
Mailing address
4472 TEEWINOT ST, CHUBBUCK, ID 83202-1736
(208) 241-7248
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
PTA2406
ID
363A00000X
Physician Assistant
Primary
PA-1301
ID
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
07/13/2008
Last updated
03/24/2016
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