Organization
TRAVIS PHYSICAL THERAPY & SPORTS MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN TODD TRAVIS ATC MS PT (PRESIDENT PHYSICAL THERAPIST)
(304) 782-1052
Entity
Organization
Contact information
Practice address
RR 1 BOX 75-3, SALEM, WV 26426-9604
(304) 782-1052
(304) 782-1053
Mailing address
RR 1 BOX 75-3, SALEM, WV 26426-9604
(304) 782-1052
(304) 782-1053
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
987
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0156442000
—
WV
Enumeration date
11/21/2006
Last updated
02/29/2008
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