Individual
CRYSTAL LYNE CARRADINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5000
Mailing address
6341 KLINES DR, GIRARD, OH 44420-1260
(330) 509-1608
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2022
Last updated
12/15/2022
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