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NPI Code Detail

MEDICARE: CARMEN TRAVIS OTR/L, OTD

MEDICARE: CARMEN TRAVIS OTR/L, OTD
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
1225X00000XOccupational Therapist008779OH

General Provider Information

NPI Number : 1801300272
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARMEN TRAVIS OTR/L, OTD
Provider Business Mailing Address
First Line : 2050 COUNTRY TRCE APT 22C
Second Line :
City : TOLEDO
State : OH
Zip : 43615-3197
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 131 N WHEELING ST
Second Line :
City : TOLEDO
State : OH
Zip : 43605-1544
Country : US
Telephone Number : 419-724-2638
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2017
Last Update Date : 11/21/2017

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Directions to “ CARMEN TRAVIS OTR/L, OTD” Practice Location

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