Most Relevant Information
Provider Data
| NPI Number: | 1003364456 |
| Provider Name: | YURIJ CHERSTYLO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/14/2016 |
| Last Updated: | 01/30/2022 |
Provider Practice Location
4646 JOHN R ST
DETROIT
MI
482011916
Practice Location Phone/Fax
| Phone: | 3135761000 |
| Fax: |
Provider Mailing Location
8027 S STATE RD
PO BOX327
GOODRICH
MI
48438
Provider Mailing Phone/Fax
| Phone: | 8106362808 |
| Fax: | 8106364010 |