Healthcare Provider Details

I. General information

NPI: 1710234224
Provider Name (Legal Business Name): TRAVIS DEE SELLERS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4365 E PECOS RD STE 125
GILBERT AZ
85295-8052
US

IV. Provider business mailing address

19927 E MAYA RD
QUEEN CREEK AZ
85142-7294
US

V. Phone/Fax

Practice location:
  • Phone: 480-550-6660
  • Fax: 480-867-1695
Mailing address:
  • Phone: 208-313-7687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9953
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: