Individual
DR. GRANT KENNETH LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1221 S CREASY LN STE A, LAFAYETTE, IN 47905-7430
(765) 447-4951
Mailing address
6301 HOOVER RD, WEST LAFAYETTE, IN 47906-9218
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18004504A
IN
Other
Enumeration date
06/10/2024
Last updated
06/12/2024
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