MEDICARE: MARIA CELESTE LYONS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2301010803	MI

General Provider Information

NPI Number	:	1760045199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA CELESTE LYONS DC

Provider Business Mailing Address
First Line	:	5536 HANLEY
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48327-2560
Country	:	US
Telephone Number	:	248-933-1125
Fax Number	:

Provider Business Practice Location Address
First Line	:	1016 N SAGINAW ST STE A
Second Line	:
City	:	HOLLY
State	:	MI
Zip	:	48442-1379
Country	:	US
Telephone Number	:	248-328-9800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2019
Last Update Date	:	06/11/2019

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Directions to “ MARIA CELESTE LYONS DC” Practice Location

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