Individual
TRAVIS DUANE QUILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D.
Contact information
Practice address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
(260) 420-0817
Mailing address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
(260) 420-0817
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002847A
IN
231H00000X
Audiologist
8628
NC
231HA2400X
Assistive Technology Practitioner Audiologist
8628
NC
231HA2500X
Assistive Technology Supplier Audiologist
8628
NC
235500000X
Speech/Language/Hearing Specialist/Technologist
8628
NC
237600000X
Audiologist-Hearing Aid Fitter
8628
NC
237700000X
Hearing Instrument Specialist
8628
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300089169
—
IN
Enumeration date
07/09/2008
Last updated
07/08/2024
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