Doctor Name: | MR. COBY JOSEPH LYONS |
NPI Number: | 1790096188 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A.-P.MIN., M.A. |
License Number: | |
Business Practice Address: | 8975 S Pecos Rd Suite 8a Henderson, NV - 890747160 |
Business Phone Number: | 7029490806 |
Business Fax Number: | 8888540782 |
Mailing Address: | 2518 Wellworth Ave, HENDERSON |
State: | NV |
Postal Code: | 890745467 |
Phone Number: | 7025755269 |
Fax Number: | |
NPI Enumeration Date: | 06/30/2010 |
NPI Last Update Date: | 06/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |