Provider Demographics
NPI:1881052496
Name:RIMER, JESSICA (CMT, CKTP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:RIMER
Suffix:
Gender:F
Credentials:CMT, CKTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 N OHIO ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-1530
Mailing Address - Country:US
Mailing Address - Phone:703-599-0265
Mailing Address - Fax:
Practice Address - Street 1:874 N OHIO ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-1530
Practice Address - Country:US
Practice Address - Phone:703-599-0265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019011103225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist