Provider Demographics
NPI:1134445349
Name:WAYBRANT, CHERYL CHRISTINE (CMT)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:CHRISTINE
Last Name:WAYBRANT
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2032 OLD HICKORY BLVD
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-2030
Mailing Address - Country:US
Mailing Address - Phone:810-280-0039
Mailing Address - Fax:
Practice Address - Street 1:2032 OLD HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-2030
Practice Address - Country:US
Practice Address - Phone:810-280-0039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist