Charles Przybylo
Individual provider Active NPI Other Technician · East Grand Rapids, MI
NPI 1336748359 · NPPES record last updated Oct 21, 2020
Key facts
- NPI
- 1336748359
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Other Technician 247200000X
- Practice address
- 2814 Woodcliff Cir SE
East Grand Rapids, MI 49506-3155 - Phone
- (517) 643-3098
- NPI assigned
- Oct 21, 2020
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | Yes |
Addresses
Primary practice location
2814 Woodcliff Cir SE
East Grand Rapids, MI 49506-3155
Mailing address
2814 Woodcliff Cir SE
East Grand Rapids, MI 49506-3155
Other providers in East Grand Rapids, MI
- Jessika Perez
- Brian V Phillips
- Susan M Phillips
- Physiotherapy Associates Inc
- Amy S Pouillon
- Anna Reeve
- Restore Therapy Collective
- Terence Roderick Reuben
- William George Schultz
- Christine Beth Sharp
All providers in East Grand Rapids, MI · Other Technician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.