Individual
TRAVIS ALAN ROSTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
3802 TURKEYFOOT RD, ELSMERE, KY 41018-2838
(859) 342-0200
Mailing address
730 WASHINGTON ST APT 212, COVINGTON, KY 41011-3042
(801) 389-4243
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-007854
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007854
—
KY
Enumeration date
11/02/2019
Last updated
11/02/2019
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