Healthcare Provider Details

I. General information

NPI: 1548081185
Provider Name (Legal Business Name): DEVON MATTHEW LYONS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 W HILLSBORO BLVD STE A11
COCONUT CREEK FL
33073-4370
US

IV. Provider business mailing address

8339 FISHERS ISLAND WAY
BOCA RATON FL
33434-5873
US

V. Phone/Fax

Practice location:
  • Phone: 954-481-2828
  • Fax: 954-481-2830
Mailing address:
  • Phone: 561-906-2125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH15236
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: