Provider Demographics
NPI:1194035683
Name:BURRELL, RONALD M SR (CERTIFIED COLON HYDR)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:M
Last Name:BURRELL
Suffix:SR
Gender:M
Credentials:CERTIFIED COLON HYDR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14100 CEDAR RD
Mailing Address - Street 2:250
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3212
Mailing Address - Country:US
Mailing Address - Phone:216-916-7757
Mailing Address - Fax:216-916-7757
Practice Address - Street 1:14100 CEDAR RD
Practice Address - Street 2:250
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44121-3212
Practice Address - Country:US
Practice Address - Phone:216-916-7757
Practice Address - Fax:216-916-7757
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXI-ACT / F-RB2101051175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath