MEDICARE: MR. DALE EDWARD LYONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT0012456	CO

General Provider Information

NPI Number	:	1063369387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DALE EDWARD LYONS

Provider Business Mailing Address
First Line	:	2861 TELLER AVE
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-5052
Country	:	US
Telephone Number	:	970-599-9545
Fax Number	:

Provider Business Practice Location Address
First Line	:	551 GRAND AVE STE 101
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-2694
Country	:	US
Telephone Number	:	970-599-9545
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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Directions to “ MR. DALE EDWARD LYONS ” Practice Location

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