MEDICARE: DR. BONNIE E TRAVIS DC

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	16563	CA

General Provider Information

NPI Number	:	1932135217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BONNIE E TRAVIS DC

Provider Business Mailing Address
First Line	:	65134 CLIFF CIR
Second Line	:
City	:	DESERT HOT SPRINGS
State	:	CA
Zip	:	92240-1486
Country	:	US
Telephone Number	:	760-671-6801
Fax Number	:

Provider Business Practice Location Address
First Line	:	65134 CLIFF CIR
Second Line	:
City	:	DESERT HOT SPRINGS
State	:	CA
Zip	:	92240-1486
Country	:	US
Telephone Number	:	760-671-6801
Fax Number	:

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

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	06/16/2016

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