Individual
TRAVIS TUPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
6201 MERLE HAY RD STE 100, JOHNSTON, IA 50131-1263
(515) 957-7790
(515) 416-9065
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
113156
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113156
STATE LICENSE
IA
Enumeration date
08/10/2022
Last updated
01/22/2026
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