Provider Demographics
NPI:1730927856
Name:TRAVIS ENTERPRISES LLC
Entity type:Organization
Organization Name:TRAVIS ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:C
Authorized Official - Last Name:TRAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:928-704-2225
Mailing Address - Street 1:2440 HWAY 95 STE A
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-7323
Mailing Address - Country:US
Mailing Address - Phone:928-704-2225
Mailing Address - Fax:928-704-0402
Practice Address - Street 1:2440 HWAY 95 STE A
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-7323
Practice Address - Country:US
Practice Address - Phone:928-704-2225
Practice Address - Fax:928-704-0402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty