Provider Demographics
NPI:1992427835
Name:CRYTSER, JUN (MAT-11228)
Entity type:Individual
Prefix:
First Name:JUN
Middle Name:
Last Name:CRYTSER
Suffix:
Gender:F
Credentials:MAT-11228
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-5656 KUAKINI HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1673
Mailing Address - Country:US
Mailing Address - Phone:808-937-8836
Mailing Address - Fax:
Practice Address - Street 1:75-5656 KUAKINI HWY STE 201
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1673
Practice Address - Country:US
Practice Address - Phone:808-937-8836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-16
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT-11228225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist