Provider Demographics
NPI:1770083925
Name:BURRELL, TROY DANIEL (BS,CBIS,ATRI)
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:DANIEL
Last Name:BURRELL
Suffix:
Gender:M
Credentials:BS,CBIS,ATRI
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Mailing Address - Street 1:3250 WEST BIG BEAVER RD
Mailing Address - Street 2:SUITE 228
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084
Mailing Address - Country:US
Mailing Address - Phone:248-792-3633
Mailing Address - Fax:
Practice Address - Street 1:3250 WEST BIG BEAVER RD
Practice Address - Street 2:SUITE 228
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084
Practice Address - Country:US
Practice Address - Phone:248-792-3633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist