Individual
LYNAE AILEEN PIERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1770 E LAKE SHORE DR, STE 100, DECATUR, IL 62521-3832
(217) 429-1512
(217) 423-1465
Mailing address
1770 E LAKE SHORE DR, STE 100, DECATUR, IL 62521-3832
(217) 429-1512
(217) 423-1465
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004984
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004984
—
IL
Enumeration date
01/31/2007
Last updated
07/09/2007
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