Individual
ANTHONY WAYNE TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3040 BATTLEFIELD PKWY, FORT OGLETHORPE, GA 30742-4004
(706) 861-6252
(706) 861-5917
Mailing address
104 SONOMA LN, RINGGOLD, GA 30736-1410
(423) 902-7144
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH015043
GA
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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