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Organization

TRAVIS PHYSICAL THERAPY & SPORTS MEDICINE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN TODD TRAVIS ATC MS PT (PRESIDENT PHYSICAL THERAPIST)
(304) 782-1052
Entity
Organization

Contact information

Practice address
RR 1 BOX 75-3, SALEM, WV 26426-9604
(304) 782-1052
(304) 782-1053
Mailing address
RR 1 BOX 75-3, SALEM, WV 26426-9604
(304) 782-1052
(304) 782-1053

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
987
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0156442000
WV
Enumeration date
09/06/2005
Last updated
09/28/2010
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