Provider Demographics
NPI:1952624892
Name:PINDER, LOREAL JEANNE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:LOREAL
Middle Name:JEANNE
Last Name:PINDER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 ELM DR
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-1118
Mailing Address - Country:US
Mailing Address - Phone:815-641-1916
Mailing Address - Fax:
Practice Address - Street 1:1129 ELM DR
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1118
Practice Address - Country:US
Practice Address - Phone:815-641-1916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-06
Last Update Date:2010-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.010085225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist