Individual
TRACY LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
825 WALTON DR, PLYMOUTH, WI 53073-5022
(920) 892-4322
Mailing address
825 WALTON DR, PLYMOUTH, WI 53073-5022
(920) 892-4322
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3187
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38887000
—
WI
Enumeration date
11/01/2006
Last updated
04/01/2013
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