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NPI Code Detail

MEDICARE: KAYLA TRAVIS LAT, ATC

MEDICARE: KAYLA TRAVIS LAT, ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic TrainerLAT-5489NC

General Provider Information

NPI Number : 1043919657
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA TRAVIS LAT, ATC
Provider Business Mailing Address
First Line : 4621 DUNCASTLE RD APT 1F
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28314-1654
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2298 LONGSTREET RD A
Second Line :
City : FORT BRAGG
State : NC
Zip : 28310-0001
Country : US
Telephone Number : 910-396-2792
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2023
Last Update Date : 10/01/2025

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Directions to “ KAYLA TRAVIS LAT, ATC” Practice Location

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