Provider Demographics
NPI:1891951927
Name:LYON, KATIE N
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:N
Last Name:LYON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 13TH ST
Mailing Address - Street 2:PO BOX 1240
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41101-3524
Mailing Address - Country:US
Mailing Address - Phone:606-325-7955
Mailing Address - Fax:
Practice Address - Street 1:11826 GALLIA PIKE STE B
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-9119
Practice Address - Country:US
Practice Address - Phone:740-574-4616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant