Individual
ELIZABETH LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT.0003123
CO
152WV0400X
Vision Therapy Optometrist
27OA00655000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72671815
—
CO
01
—
OPT.0003123
CO OPTOMETRY LICENSE
CO
Enumeration date
05/28/2015
Last updated
06/12/2019
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