Individual
TRAVIS B LOMBARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56080005712CT1
ANTHEM BCBS PROVIDER NUM
CT
01
—
7903503
AETNA PROVIDER NUMBER
CT
Enumeration date
10/16/2006
Last updated
06/03/2014
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