Provider Demographics
NPI:1548000490
Name:LYON, BRIDGET CLAIRE
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:CLAIRE
Last Name:LYON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:CLAIRE
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:347 E 4020 S
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84107-1621
Mailing Address - Country:US
Mailing Address - Phone:970-485-5412
Mailing Address - Fax:
Practice Address - Street 1:1265 E FORT UNION BLVD STE 110
Practice Address - Street 2:
Practice Address - City:COTTONWOOD HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84047-1807
Practice Address - Country:US
Practice Address - Phone:801-849-0198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13967932-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist