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Individual

TERRAN TRAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
6234 ROSE LAKE AVE, SAN DIEGO, CA 92119-3343
(509) 539-7458
Mailing address
6234 ROSE LAKE AVE, SAN DIEGO, CA 92119-3343
(509) 539-7458

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13785
CT
2251P0200X
Pediatric Physical Therapist
Primary
308255
CA

Other

Enumeration date
11/16/2022
Last updated
01/20/2026
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