Individual
DR. RICHARD THAD LYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
521 PARK AVE, CRANSTON, RI 02910-2346
(401) 781-3374
Mailing address
521 PARK AVE, CRANSTON, RI 02910-2346
(401) 781-3374
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
038007551
IL
111NN0400X
Neurology Chiropractor
Primary
DCP00601
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04506397
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/09/2006
Last updated
07/10/2012
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