Provider Demographics
NPI:1710285622
Name:LYON, MARGARET E (RDLD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:E
Last Name:LYON
Suffix:
Gender:F
Credentials:RDLD
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:E
Other - Last Name:LYON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDLD
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1007
Mailing Address - Country:US
Mailing Address - Phone:319-467-5273
Mailing Address - Fax:319-356-8674
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1007
Practice Address - Country:US
Practice Address - Phone:319-467-5273
Practice Address - Fax:319-356-8674
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00764133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered