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Individual

TRAVIS M FEATHERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1322 EISENHOWER BLVD, JOHNSTOWN, PA 15904-3307
(814) 266-8840
(814) 266-2176
Mailing address
1322 EISENHOWER BLVD, JOHNSTOWN, PA 15904-3307
(814) 266-8840
(814) 266-2176

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA054659
PA
363AM0700X
Medical Physician Assistant
Primary
MA054659
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007708200003
PA
Enumeration date
11/24/2010
Last updated
08/24/2011
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