Individual
TRAVIS L. WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
1140 W. PIONEER BLVD, MESQUITE, NV 89027
(702) 346-1899
(702) 346-8581
Mailing address
PO BOX 757, MESQUITE, NV 89024-0757
(702) 346-1899
(702) 346-8581
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1243
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003402786
—
NV
Enumeration date
10/12/2006
Last updated
08/29/2022
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