Individual
TRAVIS J. DEPTOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
180 FORT COUCH RD STE 304, PITTSBURGH, PA 15241-1041
(412) 831-0355
(412) 854-5152
Mailing address
180 FORT COUCH RD STE 304, PITTSBURGH, PA 15241-1041
(412) 831-0355
(412) 854-5152
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA063716
PA
363AM0700X
Medical Physician Assistant
Primary
MA063716
PA
Other
Enumeration date
08/29/2022
Last updated
04/14/2026
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