MEDICARE: TRAVIS BARLOW CP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224P00000X	Prosthetist	CP003850	NC

General Provider Information

NPI Number	:	1306496187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAVIS BARLOW CP

Provider Business Mailing Address
First Line	:	2826 RANDOLPH RD STE 201
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-1359
Country	:	US
Telephone Number	:	980-215-9600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2826 RANDOLPH RD STE 201
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-1359
Country	:	US
Telephone Number	:	980-215-9600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2019
Last Update Date	:	09/13/2019

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Directions to “ TRAVIS BARLOW CP” Practice Location

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