Provider Demographics
NPI:1730831454
Name:BROWDER, TRAVIS (DPT)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:
Last Name:BROWDER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4176 PLANTERS RD
Mailing Address - Street 2:
Mailing Address - City:DOLPHIN
Mailing Address - State:VA
Mailing Address - Zip Code:23843-2245
Mailing Address - Country:US
Mailing Address - Phone:434-532-6606
Mailing Address - Fax:
Practice Address - Street 1:1811 JAMESTOWN RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2326
Practice Address - Country:US
Practice Address - Phone:757-229-9991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist