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N3116 S 1 Dr, Wallace, MI 49893-9627 | |
(906) 309-0158 | |
(906) 299-5067 |
Full Name | |
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Type | Facility |
Speciality | Physical Therapist |
Location | N3116 S 1 Dr, Wallace, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1336883453 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Andrea Rose Lyon |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1699393983 PECOS PAC ID: 5294159000 Enrollment ID: I20220527001088 |
Mailing Address | Practice Location Address |
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2016 Maple Ave Unit 1021, Marinette, WI 54143-4649 Ph: (906) 309-0158 | N3116 S 1 Dr, Wallace, MI 49893-9627 Ph: (906) 309-0158 |
Andrea R Lyon, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: N3116 S 1 Dr, Wallace, MI 49893 Phone: 906-309-0158 Fax: 906-299-5067 |