Travis Dibbet, ATC
Specialist/Technologist, Athletic Trainer in Des Moines, IA. Individual provider (NPI-1).
NPI number1730694100
StatusActive
Last updated in NPPESDec 7, 2017
Details
- NPI
- 1730694100
- Entity type
- Individual (NPI-1)
- Name
- Travis Dibbet
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 7, 2017
- Last updated
- Dec 7, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 000815 | IA | Yes |
Practice location
1200 Grandview AveDes Moines, IA 50316-1529
Phone 515-263-6045
Mailing address
5092 Timberline DrWest Des Moines, IA 50265-5430
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