Individual
DR. MATT LYALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
214 BROAD ST, ELIZABETHTON, TN 37643-2714
(423) 547-2733
Mailing address
214 BROAD ST, ELIZABETHTON, TN 37643-2714
(423) 547-2733
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202205743
VA
183500000X
Pharmacist
Primary
12208
TN
Other
Enumeration date
07/05/2010
Last updated
07/05/2010
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