Provider Demographics
NPI:1730217340
Name:LYON, LONNIE (ATC)
Entity type:Individual
Prefix:MR
First Name:LONNIE
Middle Name:
Last Name:LYON
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2088 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-8664
Mailing Address - Country:US
Mailing Address - Phone:360-733-9137
Mailing Address - Fax:
Practice Address - Street 1:516 HIGH ST
Practice Address - Street 2:CV 100
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5946
Practice Address - Country:US
Practice Address - Phone:360-650-4138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer