Individual
MR. JOHN BRENNAN TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
101 S MOORE AVE, CLAREMORE, OK 74017-5047
(918) 857-0365
Mailing address
101 S MOORE AVE, CLAREMORE, OK 74017-5047
(918) 857-0365
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
117182
OK
Other
Enumeration date
08/30/2019
Last updated
08/30/2019
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