Individual
CRYSTAL MICHELLE LARIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
WESTMINSTER CANTERBURY, VIRGINIA BEACH, VA 23451
(757) 496-1100
Mailing address
1421 BRADEN CRES, NORFOLK, VA 23502-2108
(757) 724-1407
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602413
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1796563
OPTIMA HEALTH
VA
Enumeration date
12/14/2018
Last updated
12/17/2018
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