Provider Demographics
NPI:1255666970
Name:LYONS, ROBERT J (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:LYONS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4110 COPPER RIDGE DR
Mailing Address - Street 2:STE. 210
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-6722
Mailing Address - Country:US
Mailing Address - Phone:231-943-2229
Mailing Address - Fax:231-943-2231
Practice Address - Street 1:4110 COPPER RIDGE DR
Practice Address - Street 2:STE. 210
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-6722
Practice Address - Country:US
Practice Address - Phone:231-943-2229
Practice Address - Fax:231-943-2231
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN2373111N00000X
MI2301009800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor