Individual
KELLY LYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 BEAR CROSSING DR, ORLANDO, FL 32824-6004
(904) 686-4237
Mailing address
15618 CHARTER OAKS TRL, CLERMONT, FL 34711-8918
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3496
FL
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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