Individual
LISA WILLIAMS TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11835 FISHING POINT DR, NEWPORT NEWS, VA 23606-2584
(757) 243-1033
Mailing address
225 CITIZENS LN, NEWPORT NEWS, VA 23602-3711
(757) 633-5183
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A61765668
N/A
VA
Enumeration date
06/11/2021
Last updated
06/11/2021
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