Provider Demographics
NPI:1407275688
Name:IRONS, LYDIA R (LMT)
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:R
Last Name:IRONS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 HIGH ST # 2
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1810
Mailing Address - Country:US
Mailing Address - Phone:603-833-1809
Mailing Address - Fax:
Practice Address - Street 1:245 RUSSELL ST
Practice Address - Street 2:12C
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9529
Practice Address - Country:US
Practice Address - Phone:603-833-1809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9900225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist