Healthcare Provider Details

I. General information

NPI: 1558290999
Provider Name (Legal Business Name): DR. MICHAEL R. TRAVIS, DC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2299 BRODHEAD RD STE O
BETHLEHEM PA
18020-8990
US

IV. Provider business mailing address

3568 NEVILLE WAY
NAZARETH PA
18064-8002
US

V. Phone/Fax

Practice location:
  • Phone: 835-209-8816
  • Fax:
Mailing address:
  • Phone: 314-753-8393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL RYAN TRAVIS
Title or Position: OWNER
Credential: DC
Phone: 314-753-8393