Individual
TRAVIS VISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1237 E 150 S, SPANISH FORK, UT 84660-2371
(435) 705-3369
Mailing address
1237 E 150 S, SPANISH FORK, UT 84660-2371
(435) 705-3369
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
84676436006
UT
Other
Enumeration date
02/06/2014
Last updated
02/06/2014
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