Provider Demographics
NPI:1538788252
Name:MAY, TRAVIS HASAN
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:HASAN
Last Name:MAY
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 1:212 POST CANYON RD APT 205
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-5172
Mailing Address - Country:US
Mailing Address - Phone:757-917-3848
Mailing Address - Fax:
Practice Address - Street 1:3175 AZALEA GARDEN RD STE D
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513-2363
Practice Address - Country:US
Practice Address - Phone:757-588-4968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer