Individual
TRAVIS WALTER SIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC, LMT
Contact information
Practice address
74 PLANTERS RETREAT, EDISTO ISLAND, SC 29438-6987
(854) 844-3251
Mailing address
74 PLANTERS RETREAT, EDISTO ISLAND, SC 29438-6987
(854) 844-3251
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
406
SC
171100000X
Acupuncturist
65.000379
OH
225700000X
Massage Therapist
13236
SC
225700000X
Massage Therapist
33.021313
OH
Other
Enumeration date
11/28/2023
Last updated
11/28/2023
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