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Individual

TRAVIS M HENDRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1551 RENAISSANCE TOWNE DR STE 400, BOUNTIFUL, UT 84010-7676
(801) 295-7200
(801) 295-4930
Mailing address
1551 RENAISSANCE TOWNE DR STE 400, BOUNTIFUL, UT 84010-7676
(801) 295-7200
(801) 295-4930

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101245156
VA
207X00000X
Orthopaedic Surgery Physician
Primary
353125-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1124235312
UT
01
P00869950
MEDICARE RAILROAD
UT
Enumeration date
05/17/2007
Last updated
11/16/2020
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