Provider Demographics
NPI:1447665633
Name:LYON, DENNIS (DPT)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:
Last Name:LYON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 GREYSTONE PT
Mailing Address - Street 2:APT. H
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-8945
Mailing Address - Country:US
Mailing Address - Phone:336-207-3099
Mailing Address - Fax:
Practice Address - Street 1:3003 GREYSTONE PT
Practice Address - Street 2:APT. H
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-8945
Practice Address - Country:US
Practice Address - Phone:336-207-3099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP12325225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist