Provider Demographics
NPI:1053707612
Name:LYMAN, MARC
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:LYMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2367 W CHARDONNAY LN
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-1326
Mailing Address - Country:US
Mailing Address - Phone:435-313-6464
Mailing Address - Fax:
Practice Address - Street 1:676 S BLUFF ST STE 208
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3568
Practice Address - Country:US
Practice Address - Phone:435-773-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT00006397111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor