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Individual

TRAVIS DEAN RAFDAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
11790 JEFFERSON AVE, #205, NEWPORT NEWS, VA 23606
(757) 873-8701
(757) 873-6737
Mailing address
11790 JEFFERSON AVE, #205, NEWPORT NEWS, VA 23606
(757) 873-8701
(757) 873-6737

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556169
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
187447
ANTHEM BCBS
VA
Enumeration date
07/02/2006
Last updated
07/08/2007
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