Provider Demographics
NPI:1790187458
Name:LYONS, ERICA C (ATC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:C
Last Name:LYONS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:C
Other - Last Name:TAFOYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1150 YELLOW DOGWOOD HTS
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-8557
Mailing Address - Country:US
Mailing Address - Phone:970-401-1107
Mailing Address - Fax:
Practice Address - Street 1:1150 YELLOW DOGWOOD HTS
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-8557
Practice Address - Country:US
Practice Address - Phone:970-401-1107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer