Provider Demographics
NPI:1538405394
Name:RIFFEL, TRAVIS STEPHEN
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:STEPHEN
Last Name:RIFFEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 W GOFF RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67147-2652
Mailing Address - Country:US
Mailing Address - Phone:316-250-2032
Mailing Address - Fax:
Practice Address - Street 1:326 W GOFF RD
Practice Address - Street 2:
Practice Address - City:VALLEY CENTER
Practice Address - State:KS
Practice Address - Zip Code:67147-2652
Practice Address - Country:US
Practice Address - Phone:316-250-2032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant