Organization
TRAVIS LOIDOLT DO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZ SCRIVEN (CREDENTIALING)
(209) 409-2585
Entity
Organization
Contact information
Practice address
2220 E BIDWELL ST, FOLSOM, CA 95630-3463
(916) 800-4685
(916) 512-3901
Mailing address
2220 E BIDWELL ST, FOLSOM, CA 95630-3463
(916) 800-4685
(916) 512-3901
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Enumeration date
05/22/2020
Last updated
09/02/2020
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