Provider Demographics
NPI:1124657192
Name:RINER, CRYSTAL DAWN (CMT)
Entity type:Individual
Prefix:MISS
First Name:CRYSTAL
Middle Name:DAWN
Last Name:RINER
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 S LOUDOUN ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3614
Mailing Address - Country:US
Mailing Address - Phone:540-514-4443
Mailing Address - Fax:
Practice Address - Street 1:2121 S LOUDOUN ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3614
Practice Address - Country:US
Practice Address - Phone:540-514-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019006738225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist