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NPI 1023654704

NPI 1023654704 : EMILY MICHELLE TRYBUS DC : SAGINAW, MI

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General NPI Number Information
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    NPI Number           |    1023654704
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    Entity Type          |    Individual 
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    Provider Name        |    EMILY MICHELLE TRYBUS DC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/18/2019
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    Last Update Date     |    11/18/2019
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Provider Practice Location Address
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    Address Line         |    4266 STATE ST 
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    City                 |    SAGINAW
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    State                |    MI
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    Zip                  |    48603-4035
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    Country              |    US
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    Telephone            |    989-792-6702
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4266 STATE ST 
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    City                 |    SAGINAW
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    State                |    MI
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    Zip                  |    48603-4035
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    Country              |    US
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    Telephone            |    989-792-6702
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    2301010891
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    License Number State |    MI
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