Provider Demographics
NPI:1316205818
Name:WRUBEL, CRYSTAL (DC)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:
Last Name:WRUBEL
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 1:811 LIVERNOIS ST
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-2308
Mailing Address - Country:US
Mailing Address - Phone:248-439-1017
Mailing Address - Fax:
Practice Address - Street 1:811 LIVERNOIS ST
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-2308
Practice Address - Country:US
Practice Address - Phone:248-439-1017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor