Provider Demographics
NPI:1043771892
Name:LYONS, NATHAN JAMES (DC)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:JAMES
Last Name:LYONS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44005 BAYVIEW AVE APT 37211
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-7237
Mailing Address - Country:US
Mailing Address - Phone:586-321-2474
Mailing Address - Fax:
Practice Address - Street 1:35525 GARFIELD RD STE B
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-5521
Practice Address - Country:US
Practice Address - Phone:586-477-1800
Practice Address - Fax:586-477-1815
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010791111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor