Provider Demographics
NPI:1982834248
Name:PINTO, HOLLY IRENE (LMT,NCTMB)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:IRENE
Last Name:PINTO
Suffix:
Gender:F
Credentials:LMT,NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 EXECUTIVE WOODS CT
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-2016
Mailing Address - Country:US
Mailing Address - Phone:618-239-6400
Mailing Address - Fax:618-239-6444
Practice Address - Street 1:4 EXECUTIVE WOODS CT
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-2016
Practice Address - Country:US
Practice Address - Phone:618-239-6400
Practice Address - Fax:618-239-6444
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.001182225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist