Individual
TRAVIS DOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25 WOODS LAKE RD., SUITE 410, GREENVILLE, SC 29607-2763
(864) 200-2796
(864) 569-0173
Mailing address
25 WOODS LAKE RD., SUITE 410, GREENVILLE, SC 29607-2763
(864) 200-2796
(864) 569-0173
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
221569
SC
251C00000X
Developmentally Disabled Services Day Training Agency
221569
SC
251E00000X
Home Health Agency
Primary
—
SC
251S00000X
Community/Behavioral Health Agency
221569
SC
253Z00000X
In Home Supportive Care Agency
221569
SC
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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