Healthcare Provider Details

I. General information

NPI: 1972798874
Provider Name (Legal Business Name): LYONS PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 HIGH STREET
LYONS CO
80540
US

IV. Provider business mailing address

PO BOX 1960
LYONS CO
80540-1960
US

V. Phone/Fax

Practice location:
  • Phone: 303-823-8813
  • Fax: 303-823-2355
Mailing address:
  • Phone: 303-823-8813
  • Fax: 303-823-2355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number6185
License Number StateCO

VIII. Authorized Official

Name: KRISTINA DONOHOE
Title or Position: OFFICE MANAGER
Credential:
Phone: 303-823-8813