Provider Demographics
NPI:1003064783
Name:LYONNS, BROOKH SUSAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BROOKH
Middle Name:SUSAN
Last Name:LYONNS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:BROOKH
Other - Middle Name:SUSAN
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2920 S WEBSTER AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-1594
Mailing Address - Country:US
Mailing Address - Phone:920-347-4884
Mailing Address - Fax:920-347-4878
Practice Address - Street 1:2920 S WEBSTER AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-1594
Practice Address - Country:US
Practice Address - Phone:920-347-4884
Practice Address - Fax:920-347-4878
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3860-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor