Doctor Name: | DR. PAUL MATTHEW LYDON |
NPI Number: | 1043230204 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC |
License Number: | DC008039L |
Business Practice Address: | 1186 Church Street Moscow, PA - 18444 |
Business Phone Number: | 5708425131 |
Business Fax Number: | 5708425126 |
Mailing Address: | 1186 Church Street, MOSCOW |
State: | PA |
Postal Code: | 18444 |
Phone Number: | 5705581855 |
Fax Number: | 5705581856 |
NPI Enumeration Date: | 07/20/2006 |
NPI Last Update Date: | 02/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | DC008039L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |