Individual
MR. TRAVIS CRUISE WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1204 FRYE ST, ATHENS, TN 37303
(423) 745-0434
Mailing address
921 OAK GROVE RD, MADISONVILLE, TN 37354-6202
(423) 261-4161
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6973
TN
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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