Organization
CHAMPION PROFESSIONAL SERVICES
Active
Organization
CHAMPION PROFESSIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JAMES LYONS M.S,,P.T. (PRESIDENT)
(631) 828-4373
Entity
Organization
Contact information
Practice address
93 TALLMADGE TRL, MILLER PLACE, NY 11764-2327
(631) 828-4373
(631) 828-4373
Mailing address
93 TALLMADGE TRL, MILLER PLACE, NY 11764-2327
(631) 828-4373
(631) 828-4373
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
18775
NY
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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