Individual
BARRY DEAN LYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9001 S LITCHFORD RD, GRAIN VALLEY, MO 64029-8115
(816) 220-3807
Mailing address
9001 S LITCHFORD RD, GRAIN VALLEY, MO 64029-8115
(816) 220-3807
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
7303173
MO
Other
Enumeration date
04/06/2007
Last updated
07/08/2007
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