MEDICARE: TRAVIS ENTERPRISES LLC

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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1730927856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRAVIS ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	2440 HWAY 95 STE A
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-7323
Country	:	US
Telephone Number	:	928-704-2225
Fax Number	:	928-704-0402

Provider Business Practice Location Address
First Line	:	2440 HWAY 95 STE A
Second Line	:
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86442-7323
Country	:	US
Telephone Number	:	928-704-2225
Fax Number	:	928-704-0402

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	TYLER C TRAVIS
Credential	:	DC
Telephone Number	:	928-704-2225

Provider Enumeration Date	:	07/15/2024
Last Update Date	:	07/15/2024

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Directions to “TRAVIS ENTERPRISES LLC ” Practice Location

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