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General NPI Number Information
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NPI Number | 1780017772
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Entity Type | Organization
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Legal Business Name | ROBERT W. TRAVEN D.C. P.A.
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 950 N COURTENAY PKWY SUITE 11
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City | MERRITT ISLAND
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State | FL
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Zip | 32953-4501
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Country | US
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Telephone | 321-453-6126
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Fax | 321-453-8250
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Provider Business Mailing Address
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Address Line | PO BOX 540610
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City | MERRITT ISLAND
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State | FL
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Zip | 32954-0610
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Country | US
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Telephone | 321-453-6126
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Fax | 321-453-8250
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT WALTER TRAVEN
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Credential | D.C.
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Telephone | 321-453-6126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH5729
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License Number State | FL
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