Individual
TRAVIS DEAN TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
1400 NW 122ND ST, OKLAHOMA CITY, OK 73114-8027
(405) 749-8131
(405) 752-2969
Mailing address
8820 NW 116TH ST, OKLAHOMA CITY, OK 73162-2221
(405) 749-8131
(405) 752-2969
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2655
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2655
PHYSICAL THERAPY LICENSE
OK
Enumeration date
05/29/2007
Last updated
07/08/2007
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