Individual
JAMES TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.W, B.S.
Contact information
Practice address
211 N COMMERCIAL ST, NEENAH, WI 54956-2678
(920) 725-2777
Mailing address
220 WASHINGTON AVE, OSHKOSH, WI 54901-5030
(920) 236-4700
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42139300WI
—
WI
Enumeration date
09/30/2011
Last updated
09/30/2011
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