| Kimberly Dianne Lyon, OTR | |
|
4940 W 56th St, Indianapolis, IN 46254-1408 | |
| (317) 297-3115 | |
| Not Available |
| Full Name | Kimberly Dianne Lyon |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 4940 W 56th St, Indianapolis, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245968270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 1034464 (Indiana) | Primary |
| Provider Name | Healthpro Heritage Rehab & Fitness Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1053833657 PECOS PAC ID: 6507832573 Enrollment ID: O20171009003264 |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Dianne Lyon, OTR 8659 N 275 E, Pittsboro, IN 46167 Ph: (317) 489-2810 | Kimberly Dianne Lyon, OTR 4940 W 56th St, Indianapolis, IN 46254-1408 Ph: (317) 297-3115 |
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