Individual
TRAVIS JOHN LAWRENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 SOUTH AVE, ROCHESTER, NY 14620-2733
(585) 341-8130
Mailing address
1268 MAPLE CT, HORNELL, NY 14843-9657
(607) 382-5189
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F431734-01
NY
363LA2200X
Adult Health Nurse Practitioner
431734
NY
Other
Enumeration date
05/26/2020
Last updated
07/03/2023
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