Individual
TRAVIS KRAWL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
363 N UNIVERSITY AVE STE 108A, PROVO, UT 84601-8426
(801) 377-2760
Mailing address
815 S BRIDGE WAY PL STE 116, EAGLE, ID 83616-6021
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2013PCA97387
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2013PCA97387
—
UT
Enumeration date
01/13/2014
Last updated
01/13/2014
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