Healthcare Provider Details

I. General information

NPI: 1679151260
Provider Name (Legal Business Name): EMILY LYSHER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E MICHIGAN AVE STE 520
LANSING MI
48912-1899
US

IV. Provider business mailing address

804 SERVICE RD STE A202
EAST LANSING MI
48824-7015
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-5260
  • Fax: 517-364-5251
Mailing address:
  • Phone: 517-364-5260
  • Fax: 517-364-5251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number5101028198
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: