Individual
TRAVIS PACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
236 CALDWELL DR, HAZLEHURST, MS 39083-2723
(601) 894-9004
Mailing address
2416 HIGHWAY 45 N, COLUMBUS, MS 39705-1320
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5366
MS
Other
Enumeration date
11/26/2014
Last updated
01/25/2017
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