Healthcare Provider Details

I. General information

NPI: 1265907711
Provider Name (Legal Business Name): TRAVIS TURCER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 10/15/2021
Certification Date: 10/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 8TH ST
CLERMONT FL
34711-2159
US

IV. Provider business mailing address

3686 DODGESON RD
ALEXANDER NY
14005-9791
US

V. Phone/Fax

Practice location:
  • Phone: 352-243-4422
  • Fax: 407-743-3357
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number040712
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: