Organization
BODYLOGICMD OF ENCINO P.C.
Active
Other names
BodyLogicMD of Encino
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS DEUSON M.D. (DIRECTOR)
(877) 835-1536
Entity
Organization
Contact information
Practice address
16260 VENTURA BLVD, SUITE 105, ENCINO, CA 91436-2203
(877) 835-1536
(877) 835-1537
Mailing address
27023 MCBEAN PKWY, 83, VALENCIA, CA 91355-5145
(877) 835-1536
(877) 835-1537
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A69979
CA
Other
Enumeration date
03/27/2009
Last updated
05/08/2009
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