Individual
MRS. DANIELLE TRAVISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
227 MEDICAL PARK DR, STE101, BRIDGEPORT, WV 26330-9038
(681) 342-3490
Mailing address
227 MEDICAL PARK DR, STE101, BRIDGEPORT, WV 26330-9038
(681) 342-3490
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-04351
NC
363A00000X
Physician Assistant
Primary
01778
WV
Other
Enumeration date
11/02/2013
Last updated
03/07/2023
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