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Individual
DR. TRAVIS ANDERSON
Active
Individual
DR. TRAVIS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2747
CO
152WC0802X
Corneal and Contact Management Optometrist
Primary
2747
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07920865
—
CO
Enumeration date
09/14/2009
Last updated
04/21/2020
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