Individual
NICHOLAS BRUSSTAR TRAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
14557 W INDIAN SCHOOL RD # 500, GOODYEAR, AZ 85395-9218
(623) 242-6908
Mailing address
13226 N 79TH ST, SCOTTSDALE, AZ 85260-4016
(480) 266-1995
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-30985
AZ
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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