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Individual
TRAVIS JOHN POULSON
Active
Individual
TRAVIS JOHN POULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, CSCS
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT-713
ID
Other
Enumeration date
03/27/2021
Last updated
03/27/2021
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