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NPI Code Detail

MEDICARE: CHELSEA JOHNSON-TRAVIS

MEDICARE:   CHELSEA  JOHNSON-TRAVIS
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1710316609
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEA JOHNSON-TRAVIS
Provider Business Mailing Address
First Line : 5005 LOSEE RD
Second Line : APT 1136
City : NORTH LAS VEGAS
State : NV
Zip : 89081-2479
Country : US
Telephone Number : 404-932-3878
Fax Number :
Provider Business Practice Location Address
First Line : 5005 LOSEE RD
Second Line : APT 1136
City : NORTH LAS VEGAS
State : NV
Zip : 89081-2479
Country : US
Telephone Number : 404-932-3878
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2013
Last Update Date : 11/01/2013

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Directions to “ CHELSEA JOHNSON-TRAVIS ” Practice Location

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