Individual
JEANETTE RENEE LUNDELL
Active
Individual
JEANETTE RENEE LUNDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MSG010470
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MSG010470
PA LICENSE
PA
Enumeration date
06/13/2018
Last updated
06/13/2018
Update your record
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