Individual
TRAVIS HENMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6051 W EMERALD ST, BOISE, ID 83704-8969
(208) 302-5150
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 302-9342
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-1681
ID
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/30/2018
Last updated
05/15/2024
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