Individual
MR. TRAVIS LYTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
411 HUKU LII PL STE 101, KIHEI, HI 96753-7062
(808) 879-0077
(808) 879-0177
Mailing address
411 HUKU LII PL STE 101, KIHEI, HI 96753-7062
(808) 879-0077
(808) 879-0177
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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