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General NPI Number Information
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NPI Number | 1629740915
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Entity Type | Individual
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Provider Name | TRAVIS HENDRIX
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Gender | Male
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 2460 GLEBE ST
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City | CARMEL
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State | IN
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Zip | 46032-7154
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Country | US
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Telephone | 317-733-9560
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Fax |
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Provider Business Mailing Address
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Address Line | 70 MARKLEVILLE LN
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City | WESTFIELD
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State | IN
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Zip | 46074-8433
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 32002076A
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License Number State | IN
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