Provider Demographics
NPI:1730343963
Name:LYON, ALEXANDREA (DC)
Entity type:Individual
Prefix:
First Name:ALEXANDREA
Middle Name:
Last Name:LYON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 BASELINE RD
Mailing Address - Street 2:STE 301
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2366
Mailing Address - Country:US
Mailing Address - Phone:303-442-4006
Mailing Address - Fax:303-442-4070
Practice Address - Street 1:2935 BASELINE RD
Practice Address - Street 2:STE 301
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2366
Practice Address - Country:US
Practice Address - Phone:303-442-4006
Practice Address - Fax:303-442-4070
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3474111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition