Provider Demographics
NPI:1144976291
Name:RIEGEL, CHRISTINE S (LMT LICENSED MASSAGE)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:S
Last Name:RIEGEL
Suffix:
Gender:F
Credentials:LMT LICENSED MASSAGE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 LOCKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-4266
Mailing Address - Country:US
Mailing Address - Phone:605-391-3966
Mailing Address - Fax:
Practice Address - Street 1:2210 LOCKWOOD DR
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-4266
Practice Address - Country:US
Practice Address - Phone:605-391-3966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDMT11718225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty