Individual
TRAVIS J NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4201B ANDERSON AVE, SUITE 1, MANHATTAN, KS 66503-7601
(785) 539-5555
(785) 539-4551
Mailing address
426A MCCALL RD, MANHATTAN, KS 66502-5032
(785) 776-0670
(785) 776-0096
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1103824
KS
2251X0800X
Orthopedic Physical Therapist
0012597
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104037751
BCBS KS
KS
05
—
201182370A
—
KS
01
—
44204046
BCBS KC
—
01
—
KA2868020
MEDICARE PTAN
KS
Enumeration date
06/29/2010
Last updated
09/29/2020
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