Individual
LISA LYDSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
137 HOSPITAL DR NE, FORT WALTON BEACH, FL 32548-5063
(850) 833-7451
(850) 833-7439
Mailing address
137 HOSPITAL DR NE, FORT WALTON BEACH, FL 32548-5063
(850) 833-7451
(850) 833-7439
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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