Individual
DR. VINCENT LOUIS TRAVISANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
7509 BIG BEND BLVD, SAINT LOUIS, MO 63119-2103
(314) 961-3113
(314) 968-7529
Mailing address
7509 BIG BEND BLVD, SAINT LOUIS, MO 63119-2103
(314) 961-3113
(314) 968-7529
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
000459
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301841607
—
MO
Enumeration date
01/22/2006
Last updated
06/13/2013
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