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General NPI Number Information
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NPI Number | 1205354156
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Entity Type | Individual
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Provider Name | MATTHEW LYONS PT, DPT, OCS, CSCS
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Gender | Male
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE
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City | TACOMA
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State | WA
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Zip | 98431-3610
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Country | US
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Telephone | 252-968-2252
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Fax |
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Provider Business Mailing Address
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Address Line | 32 W ESTHER ST UNIT C
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City | ORLANDO
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State | FL
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Zip | 32806-3926
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Country | US
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Telephone | 484-832-5845
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT34619
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License Number State | FL
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