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General NPI Number Information
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NPI Number | 1386736171
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Entity Type | Organization
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Legal Business Name | NEUROLOGIC ASSOCIATES OF LAKE COUNTY, INC.
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7879 AUBURN RD 1-D
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City | PAINESVILLE
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State | OH
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Zip | 44077-9178
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Country | US
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Telephone | 440-639-6550
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Fax | 440-639-6553
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Provider Business Mailing Address
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Address Line | 7879 AUBURN RD 1-D
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City | PAINESVILLE
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State | OH
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Zip | 44077-9178
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Country | US
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Telephone | 440-639-6550
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Fax | 440-639-6553
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MRS. DOROTHY ARALINE LYONS
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Credential | M.D.
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Telephone | 440-639-6550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 35045475L
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License Number State | OH
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