Provider Demographics
NPI:1821033473
Name:LYONS, JOEL ROBERT (PT)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:ROBERT
Last Name:LYONS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7865 TRINITY RD STE 108
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-2274
Mailing Address - Country:US
Mailing Address - Phone:901-737-4035
Mailing Address - Fax:901-737-4038
Practice Address - Street 1:7865 TRINITY RD STE 108
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-2274
Practice Address - Country:US
Practice Address - Phone:901-737-4035
Practice Address - Fax:901-737-4038
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT3534225100000X
TNPT17122251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN446538Medicare Oscar/Certification
MS256594Medicare Oscar/Certification