Provider Demographics
NPI:1104683085
Name:STENGER, TRAVIS (MS)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:
Last Name:STENGER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14485 NORTHLAND DR
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-2368
Mailing Address - Country:US
Mailing Address - Phone:231-465-1934
Mailing Address - Fax:231-796-7864
Practice Address - Street 1:14485 NORTHLAND DR
Practice Address - Street 2:
Practice Address - City:BIG RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49307-2368
Practice Address - Country:US
Practice Address - Phone:231-465-1934
Practice Address - Fax:231-796-7864
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator