Provider Demographics
NPI:1831642503
Name:RHINER, CORY
Entity Type:Individual
Prefix:
First Name:CORY
Middle Name:
Last Name:RHINER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7326 GREENHAVEN AVE APT 68
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-7303
Mailing Address - Country:US
Mailing Address - Phone:909-319-1614
Mailing Address - Fax:
Practice Address - Street 1:7326 GREENHAVEN AVE APT 68
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-7303
Practice Address - Country:US
Practice Address - Phone:909-319-1614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT738225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant