Provider Demographics
NPI:1467637587
Name:BRIAN T LYMAN D C INC
Entity Type:Organization
Organization Name:BRIAN T LYMAN D C INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-750-6909
Mailing Address - Street 1:585 W 100 N
Mailing Address - Street 2:SUITE E
Mailing Address - City:PROVIDENCE
Mailing Address - State:UT
Mailing Address - Zip Code:84332-9876
Mailing Address - Country:US
Mailing Address - Phone:435-750-6909
Mailing Address - Fax:
Practice Address - Street 1:585 W 100 N
Practice Address - Street 2:SUITE E
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-9876
Practice Address - Country:US
Practice Address - Phone:435-750-6909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT295371-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT86070061777001OtherBLUE CROSS BLUE SHIELD
UT870395551LY1OtherEMIA
UT10034OtherALTIUS
UT39158OtherPEHP
UT86070061777001OtherBLUE CROSS BLUE SHIELD
UT39158OtherPEHP