Individual
JOHNATHAN ANDREW LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 S GROVE ST, PETERSBURG, WV 26847-1770
(304) 257-2451
(304) 257-1263
Mailing address
PO BOX 97, BAKER, WV 26801-0097
(304) 897-5915
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00945109
WV
Other
Enumeration date
06/27/2017
Last updated
06/27/2017
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