Individual
TRAVIS COLT MCCUBBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1025 PENNOCK PL, FORT COLLINS, CO 80524-3257
(970) 495-8803
(970) 495-8891
Mailing address
1025 PENNOCK PL, FORT COLLINS, CO 80524-3257
(970) 495-8803
(970) 495-8891
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR.0065664
CO
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/31/2019
Last updated
07/21/2021
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