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General NPI Number Information
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NPI Number | 1346541117
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Entity Type | Organization
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Legal Business Name | TRAVIS REBER DPM PLLC
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Dates
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Enumeration Date | 11/10/2010
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Last Update Date | 10/28/2011
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Provider Practice Location Address
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Address Line | 940 N SWITZER CANYON DR STE 102
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-4852
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Country | US
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Telephone | 928-779-5111
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Fax | 928-779-1374
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Provider Business Mailing Address
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Address Line | 940 N SWITZER CANYON DR STE 102
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-4852
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Country | US
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Telephone | 928-779-5111
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Fax | 928-779-1374
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Authorized Official
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Title or Position | OWNER
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Name | TRAVIS K REBER
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Credential | DPM
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Telephone | 928-779-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | AZ0659
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License Number State | AZ
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