Individual
MR. TRAVIS LYTLE
Active
Individual
MR. TRAVIS LYTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
6994
CT
2251X0800X
Orthopedic Physical Therapist
Primary
5519
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080006994CT24
ANTHEM BC BS
CT
Enumeration date
10/20/2006
Last updated
12/30/2022
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