Doctor Name: | MS. PANDY M. OLMSTEAD |
NPI Number: | 1619174471 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 153 E Laurel Ave #203 Lake Forest, IL - 600455407 |
Business Phone Number: | 8475289880 |
Business Fax Number: | 8477359611 |
Mailing Address: | 736 N Western Ave, #319 LAKE FOREST |
State: | IL |
Postal Code: | 600451820 |
Phone Number: | 8475289880 |
Fax Number: | 8477359611 |
NPI Enumeration Date: | 06/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |