Provider Demographics
NPI:1720350762
Name:LYONS, TIMOTHY JAMES JR (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JAMES
Last Name:LYONS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5336
Mailing Address - Country:US
Mailing Address - Phone:973-228-0500
Mailing Address - Fax:973-228-0501
Practice Address - Street 1:110 BLOOMFIELD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5336
Practice Address - Country:US
Practice Address - Phone:973-228-0500
Practice Address - Fax:973-228-0501
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00698100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor