Individual
TRAVIS W STRATFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., L.C.P.C.
Contact information
Practice address
1703 RIVER RANCH RD, MISSOULA, MT 59804-8503
(406) 317-3115
Mailing address
1703 RIVER RANCH RD, MISSOULA, MT 59804-8503
(406) 317-3115
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
47167
MT
101YP2500X
Professional Counselor
Primary
47167
MT
2085R0202X
Diagnostic Radiology Physician
26978
OR
2085R0204X
Vascular & Interventional Radiology Physician
MD46039
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
271184
—
OR
Enumeration date
05/13/2006
Last updated
01/11/2021
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