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Individual

MR. TRAVIS J ANDERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1624 CLARENCE CT, WEST BEND, WI 53095-8533
(262) 334-4847
(262) 334-5554
Mailing address
1624 CLARENCE CT, WEST BEND, WI 53095-8533
(262) 334-4847
(262) 334-5554

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3952012
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38946400
WI
Enumeration date
07/31/2006
Last updated
07/08/2007
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