Individual
JACOB LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 456-0857
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5151016567
MI
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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