Healthcare Provider Details

I. General information

NPI: 1801332887
Provider Name (Legal Business Name): ROBERT WRUBEL MA, CLVT, COMS, CVRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2017
Last Update Date: 01/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 IRVING ST NW
WASHINGTON DC
20422-0001
US

IV. Provider business mailing address

604 UNION ST
EATON RAPIDS MI
48827-1371
US

V. Phone/Fax

Practice location:
  • Phone: 517-285-4099
  • Fax:
Mailing address:
  • Phone: 517-285-4099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255R0406X
TaxonomyBlind Rehabilitation Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: