Individual
MR. TRAVIS JEFFREY PEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
10100 US HIGHWAY 231, UTICA, KY 42376-9340
(270) 925-0024
Mailing address
10100 US HIGHWAY 231, UTICA, KY 42376-9340
(270) 925-0024
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
KY3559
KY
Other
Enumeration date
04/26/2010
Last updated
04/26/2010
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