Individual
MS. LORI LYONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5710 NEWARK RD, MOUNT VERNON, OH 43050-9561
(740) 392-4586
(740) 392-4586
Mailing address
5710 NEWARK RD, MOUNT VERNON, OH 43050-9561
(740) 392-4586
(740) 392-4586
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0169181
ODJFS MEDICAID PROVIDER NUMBER:
OH
Enumeration date
06/16/2016
Last updated
06/16/2016
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