Most Relevant Information
Provider Data
| NPI Number: | 1003407602 |
| Provider Name: | JUSTIN LYONS PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 2158925 |
Most Important Dates
| Enumeration Date: | 01/27/2021 |
| Last Updated: | 01/27/2021 |
Provider Practice Location
1201 HEWITT DR STE 107
WACO
TX
767128834
Practice Location Phone/Fax
| Phone: | 2545728890 |
| Fax: |
Provider Mailing Location
1201 HEWITT DR STE 107
WACO
TX
767128834
Provider Mailing Phone/Fax
| Phone: | 2545728890 |
| Fax: |