Provider Demographics
NPI:1568843597
Name:WISBISKI, SABRINA
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:WISBISKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 FELLRATH
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-2015
Mailing Address - Country:US
Mailing Address - Phone:586-329-9255
Mailing Address - Fax:313-831-2608
Practice Address - Street 1:6130 FELLRATH
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-2015
Practice Address - Country:US
Practice Address - Phone:586-329-9255
Practice Address - Fax:313-831-2608
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other