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General NPI Number Information
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NPI Number | 1083090856
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Entity Type | Individual
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Provider Name | TRAVIS S MCGILL DPT
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Gender | Male
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 9540 N GARNETT RD STE 101
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City | OWASSO
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State | OK
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Zip | 74055-4410
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Country | US
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Telephone | 918-609-1300
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Fax | 918-609-1318
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Provider Business Mailing Address
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Address Line | 9070 W CHEYENNE AVE STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89129-8935
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Country | US
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Telephone | 702-818-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5041
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License Number State | OK
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