Organization
LYONS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE C LYONS PT (OWNER)
(208) 484-2134
Entity
Organization
Contact information
Practice address
770 S 13TH ST, UNIT 6581, BOISE, ID 83707-0002
(208) 484-2134
Mailing address
PO BOX 6581, BOISE, ID 83707-0581
(208) 484-2134
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1156
ID
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
1156
ID
282N00000X
General Acute Care Hospital
1156
ID
302R00000X
Health Maintenance Organization
1156
ID
305R00000X
Preferred Provider Organization
1156
ID
305S00000X
Point of Service
1156
ID
Other
Enumeration date
05/03/2016
Last updated
05/03/2016
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