Amanda Rose Travis, MSPT
Physical Therapist in Wyoming, MI. Individual provider (NPI-1).
NPI number1982106670
StatusActive
Last updated in NPPESMar 8, 2018
Details
- NPI
- 1982106670
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Amanda Rose Travis
- Credential
- MSPT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 8, 2018
- Last updated
- Mar 8, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 5501012166 | MI | Yes |
Practice location
6105 Wilson Ave SwWyoming, MI 49418-9714
Phone 616-486-5055
Mailing address
6105 Wilson Ave SwWyoming, MI 49418-9714
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