Provider Demographics
NPI:1790096188
Name:LYONS, COBY JOSEPH (MA-PMIN, MA)
Entity Type:Individual
Prefix:MR
First Name:COBY
Middle Name:JOSEPH
Last Name:LYONS
Suffix:
Gender:M
Credentials:MA-PMIN, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 WELLWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-5467
Mailing Address - Country:US
Mailing Address - Phone:702-575-5269
Mailing Address - Fax:
Practice Address - Street 1:8975 S PECOS RD
Practice Address - Street 2:SUITE 8A
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7160
Practice Address - Country:US
Practice Address - Phone:702-949-0806
Practice Address - Fax:888-854-0782
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program