Individual
TRAVIS PAUL PASILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6000 W OLIVE AVE, GLENDALE, AZ 85302-3006
(951) 317-1008
Mailing address
2811 W DEER VALLEY RD APT 2076, PHOENIX, AZ 85027-2391
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1655
AZ
Other
Enumeration date
10/18/2017
Last updated
10/18/2017
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