Individual
MR. TRAVIS MICHAEL TIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MMS, PA-C, ATC, M ED
Contact information
Practice address
1675 E MELROSE ST STE 101-103, GILBERT, AZ 85297-1001
(602) 648-5444
(602) 772-3801
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5008
AZ
363AS0400X
Surgical Physician Assistant
5008
AZ
Other
Enumeration date
04/20/2007
Last updated
07/29/2022
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