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Individual

GRACE PINEDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
201 S 14TH ST, HERRIN, IL 62948-3631
(618) 942-2171
Mailing address
2771 KOKOPELLI DR, MARION, IL 62959-5242
(618) 998-8833

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.012509
IL

Other

Enumeration date
11/15/2010
Last updated
11/15/2010
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