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Individual

MR. COURTNEY TAYLOR LYMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
50 S STATE ST, LA VERKIN, UT 84745-5443
(877) 698-4968
Mailing address
50 S STATE ST, LA VERKIN, UT 84745-5443
(877) 698-4968

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
225400000X
Rehabilitation Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1114457843
UT
Enumeration date
04/25/2013
Last updated
01/27/2020
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