Lyra Rivera Phan, PT

NPI #1023142601 in Florissant, Missouri

Provider Information

NPI Number: 1023142601
Entity Type: Individual
Name: Lyra Rivera Phan, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Mar 15, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 250 NEW FLORISSANT RD S
City: Florissant
State: Missouri
ZIP Code: 63013
Phone: (314) 830-7950

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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