Individual
DR. TRAVIS J DICHOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 E LEHIGH AVE SUITE 305B, PHILADELPHIA, PA 19125
(215) 707-3351
Mailing address
100 E LEHIGH AVE SUITE 305B, PHILADELPHIA, PA 19125
(215) 706-3351
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
OT018006
PA
2084P0800X
Psychiatry Physician
Primary
OT018006
PA
Other
Enumeration date
06/02/2017
Last updated
07/21/2022
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