Individual
DR. TRAVIS R WILKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
528 N STATE ST, SHELLEY, ID 83274-1154
(208) 357-0333
(208) 357-2299
Mailing address
528 N STATE ST, SHELLEY, ID 83274-1154
(208) 357-0333
(208) 357-2299
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-973
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C4009
BLUE CROSS
ID
Enumeration date
07/10/2006
Last updated
07/09/2007
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