MS. Lucetta Lynne Lyford, PA-C

NPI #1396749800 in Portage, Michigan

Provider Information

NPI Number: 1396749800
Entity Type: Individual
Name: MS. Lucetta Lynne Lyford, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jun 13, 2005
Last Updated: Aug 7, 2007

Practice Location

Address: 430 W. CENTRE AVE.
City: Portage
State: Michigan
ZIP Code: 49024
Phone: (269) 321-6673

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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