MEDICARE: DR. TYLER 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	8809	AZ

General Provider Information

NPI Number	:	1932769114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TYLER TRAVIS DC

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	:

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	:

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

Provider Enumeration Date	:	06/19/2019
Last Update Date	:	06/19/2019

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Directions to “ DR. TYLER TRAVIS DC” Practice Location

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