Provider Demographics
NPI:1558535435
Name:LYON, HOPE (LMT)
Entity Type:Individual
Prefix:MS
First Name:HOPE
Middle Name:
Last Name:LYON
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 1:11909 MCAULEY DR
Mailing Address - Street 2:SUITE 100 A2
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-1793
Mailing Address - Country:US
Mailing Address - Phone:912-925-3767
Mailing Address - Fax:912-925-3659
Practice Address - Street 1:11909 MCAULEY DR
Practice Address - Street 2:SUITE 100 A2
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1793
Practice Address - Country:US
Practice Address - Phone:912-925-3767
Practice Address - Fax:912-925-3659
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT001568225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAMT001568OtherMT