Provider Demographics
NPI:1275560054
Name:TERRILL, MICHAEL BURTON (ATC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:BURTON
Last Name:TERRILL
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 BELMEADE ST
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5733
Mailing Address - Country:US
Mailing Address - Phone:325-649-8101
Mailing Address - Fax:325-649-8908
Practice Address - Street 1:1000 FISK AVE
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-2715
Practice Address - Country:US
Practice Address - Phone:325-649-8101
Practice Address - Fax:325-649-8908
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT 15862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer