Provider Demographics
NPI:1497434104
Name:BYBEE, CHRISTOPHER
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:
Last Name:BYBEE
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:HARDY
Other - Middle Name:
Other - Last Name:HARDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:908 W CHANDLER BLVD # A
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2548
Mailing Address - Country:US
Mailing Address - Phone:480-648-8573
Mailing Address - Fax:
Practice Address - Street 1:908 W CHANDLER BLVD # A
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2548
Practice Address - Country:US
Practice Address - Phone:480-648-8573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD01640665172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver