Provider Demographics
NPI:1821226044
Name:LYONNAIS, TODD M (PT)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:M
Last Name:LYONNAIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:989 S. MAIN STREET
Mailing Address - Street 2:STE. A, #278
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-5449
Mailing Address - Country:US
Mailing Address - Phone:928-634-1900
Mailing Address - Fax:928-634-1906
Practice Address - Street 1:1329 E HIGHWAY 89A STE D
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-6252
Practice Address - Country:US
Practice Address - Phone:928-634-1900
Practice Address - Fax:928-634-1906
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8534225100000X, 2251G0304X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ8534OtherPHYSICAL THERAPY LICENSE NUMBER