Provider Demographics
NPI:1588252324
Name:BURGER, TROY (ATC)
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:
Last Name:BURGER
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 1:308 PITSENBARGER BLVD
Mailing Address - Street 2:
Mailing Address - City:JOINT BASE LEWIS MCCHORD
Mailing Address - State:WA
Mailing Address - Zip Code:98438-1201
Mailing Address - Country:US
Mailing Address - Phone:253-982-9950
Mailing Address - Fax:
Practice Address - Street 1:308 PITSENBARGER BLVD
Practice Address - Street 2:
Practice Address - City:JOINT BASE LEWIS MCCHORD
Practice Address - State:WA
Practice Address - Zip Code:98438-1201
Practice Address - Country:US
Practice Address - Phone:253-982-9950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5592083S0010X, 2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine