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General NPI Number Information
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NPI Number | 1275030827
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Entity Type | Individual
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Provider Name | KIRSTIN AINSLEY LYONS DC
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Gender | Female
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 04/10/2018
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Provider Practice Location Address
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Address Line | 200 INDUSTRIAL BLVD STE 108
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City | ELLIJAY
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State | GA
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Zip | 30540-3721
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Country | US
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Telephone | 706-636-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 200 INDUSTRIAL BLVD STE 108
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City | ELLIJAY
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State | GA
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Zip | 30540-3721
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Country | US
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Telephone | 706-636-4325
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIRO010053
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License Number State | GA
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