MEDICARE: DR. TRAVIS ROBERT MOHR D.C.

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
1	111NR0400X	Rehabilitation Chiropractor	CH9784	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275765463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRAVIS ROBERT MOHR D.C.

Provider Business Mailing Address
First Line	:	17429 BRIDGE HILL CT
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3467
Country	:	US
Telephone Number	:	813-983-7921
Fax Number	:	813-333-2788

Provider Business Practice Location Address
First Line	:	17429 BRIDGE HILL CT
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3467
Country	:	US
Telephone Number	:	813-990-9285
Fax Number	:	813-319-3486

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2009
Last Update Date	:	08/27/2018

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