Individual provider · Type 1 NPI

Lyndon Tyrone Willis I

Student in an Organized Health Care Education/Training Program · Elyria, OH

NPI number 1891263489 Active

Practice location

347 Midway Blvd Ste 210
Elyria, OH 44035-2496

Call (440) 324-5555 Map

Fax (440) 324-5512

Mailing address

9206 Plymouth Ave
Garfield Heights, OH 44125-2361

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: 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.

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About NPI 1891263489

Lyndon Tyrone Willis I's National Provider Identifier is 1891263489, issued on Nov 13, 2018. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Elyria, OH. The record was last updated on Nov 13, 2018.