BYRAN KENDALL BULLOCK (NPI# 1154806891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154806891 |
| Entity Type | Individual |
| Full Name | BYRAN KENDALL BULLOCK |
| Practice Address |
3250 W Big Beaver Rd Ste 228 Troy MI 48084-2909 |
| Mailing Address |
1400 E Jarvis Ave Hazel Park MI 48030-1944 |
| Practice Telephone | 2487923633 |
| Mailing Telephone | 7045129316 |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2018-09-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 7501008226 | MI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3250 W BIG BEAVER RD STE 228 |
| City | TROY |
| State | MI |
| Zip Code | 48084-2909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912437963 | Sharlie Raye Edwards | Massage Therapist | 3250 W Big Beaver Rd Ste 228, Troy, MI 48084-2909 | 2017-06-13 |
| 1124660832 | Jennifer Lynn Prong | Kinesiotherapist | 3250 W Big Beaver Rd Ste 228, Troy, MI 48084-2909 | 2019-10-14 |
| 1912409871 | Onward Personal Training LLC | Recreation Therapist | 3250 W Big Beaver Rd Ste 228, Troy, MI 48084 | 2018-03-06 |
| 1629577168 | Brenna Hammond | Kinesiotherapist | 3250 W Big Beaver Rd Ste 228, Troy, MI 48084-2909 | 2018-02-11 |
| 1386143246 | Nick Lajiness | Kinesiotherapist | 3250 W Big Beaver Rd Ste 228, Troy, MI 48084-2909 | 2018-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497360242 | Keely Erin Zuri | Physical Therapy Assistant | 3250 W. Big Beaver, Troy, MI 48084 | 2020-09-09 |
| 1841762473 | Hunter Thomas Michaels | Kinesiotherapist | 3250 West Big Beaver Rd, Suite 228, Troy, MI 48084 | 2018-12-20 |
| 1265900864 | Michelle Denise Carter | Massage Therapist | 3250 West Big Beaver Suite 228, Troy, MI 48084 | 2018-11-13 |
| 1770083925 | Troy Daniel Burrell | Clinical Exercise Physiologist | 3250 West Big Beaver Rd, Suite 228, Troy, MI 48084 | 2018-02-14 |
| 1174030175 | Alexander Scott | Kinesiotherapist | 3250 W. Big Beaver Rd., Troy, MI 48084 | 2017-12-29 |
| 1568977213 | Mallory Rose Valeri | Specialist/Technologist | 3250 W. Big Beaver Rd, Suite 228, Troy, MI 48084 | 2017-12-04 |
| 1710409651 | Eduardo Martin Pinto | Pharmacist | 3811 Coolidge Hwy, Troy, MI 48084 | 2017-07-12 |
| 1659891653 | Tricia Michelle Forgash | Recreation Therapist | 1998 Dorchester Dr. N 106, Troy, MI 48084 | 2017-06-21 |
| 1851759278 | Lauren Field | Counselor | 3290 W Big Beaver Rd Ste 188, Troy, MI 48084 | 2016-01-30 |
| 1265806939 | Tammy Scott-barney | Nurse Practitioner | 888 W Big Beaver Rd Ste 900, Troy, MI 48084 | 2015-11-18 |
| Find all providers in zip 48084 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033732748 | Kyle Adam Conatser | Massage Therapist | 220 Elba Hwy, Troy, AL 36079-5000 | 2020-05-28 |
| 1528616232 | Gwendolyn Eve Guarino | Massage Therapist | Lux, 207 River St, Troy, NY 12180 | 2019-08-27 |
| 1346801594 | Emily Ann Mcroberts | Massage Therapist | 3190 Rochester Rd Ste 107, Troy, MI 48083-5464 | 2019-06-27 |
| 1831663111 | Rebecca Tamm | Massage Therapist | 330 E Maple Rd Ste H, Troy, MI 48083-2706 | 2019-01-19 |
| 1265900864 | Michelle Denise Carter | Massage Therapist | 3250 West Big Beaver Suite 228, Troy, MI 48084 | 2018-11-13 |
| 1255842571 | Indigo Sunshine Studio LLC | Massage Therapist | 1926 W Main St, Troy, OH 45373-1017 | 2017-10-13 |
| 1912437963 | Sharlie Raye Edwards | Massage Therapist | 3250 W Big Beaver Rd Ste 228, Troy, MI 48084-2909 | 2017-06-13 |
| 1578002473 | Matthew Weaver | Massage Therapist | 51 S. Stanfield Rd., Troy, OH 45373-2992 | 2017-02-13 |
| 1255881884 | Toni Ann Ridge | Massage Therapist | 419 S 3 Notch St, Troy, AL 36081-2541 | 2016-10-06 |
| 1386040103 | Leticia Lanay Allison-clark | Massage Therapist | 100 West Collier Street, Troy, MO 63379-3350 | 2014-11-05 |
| Find all providers in TROY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.