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Contact Information

EARL L GRINE JR, PT, MSPT, ATC, CSCS
11800 SUNRISE VALLEY DR
100
RESTON, VA20191
 Phone: 703-709-1116
 Fax: 703-709-5134
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for EARL L GRINE JR · (Male)

NPI # 1346323474
Status Active
Credentials PT, MSPT, ATC, CSCS
Entity Individual
Enumeration date 10/23/2006
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 2305202763
  • DC Other 604546000 DEPARTMENT OF LABOR
  • VA Other 172810 BLUE CROSS / BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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