Provider Demographics
NPI:1114432952
Name:LYONS, LUKE RICHARD (DPT)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:RICHARD
Last Name:LYONS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 SE MOBERLY LN STE 6
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-7017
Mailing Address - Country:US
Mailing Address - Phone:479-715-6330
Mailing Address - Fax:479-268-5144
Practice Address - Street 1:3290 NE 65TH STREET
Practice Address - Street 2:UNIT 101
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115
Practice Address - Country:US
Practice Address - Phone:206-388-2549
Practice Address - Fax:206-829-4352
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60806911225100000X
225100000X
ARPT4955225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist