Provider Demographics
NPI:1023654704
Name:TRYBUS, EMILY MICHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:MICHELLE
Last Name:TRYBUS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4266 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-4035
Mailing Address - Country:US
Mailing Address - Phone:989-792-6702
Mailing Address - Fax:
Practice Address - Street 1:4266 STATE ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-4035
Practice Address - Country:US
Practice Address - Phone:989-792-6702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor