Individual
TRAVIS ROY TORNGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
360 E MAIN ST, REXBURG, ID 83440-2015
(208) 356-9550
(208) 356-8023
Mailing address
360 E MAIN ST, REXBURG, ID 83440-2015
(208) 356-9550
(415) 928-1035
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M-11045
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184799298
—
ID
Enumeration date
04/27/2007
Last updated
01/24/2017
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