Andersen, Travis J
Andersen, Travis J is an sole proprietor health care provider with primary practice located at 1624 Clarence Ct , West Bend WI 53095-8533. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Andersen, Travis J can be contacted via phone (262) 334-4847.Contact Information
Primary practice address
1624 Clarence Ct
West Bend WI 53095-8533
Phone: (262) 334-4847
Fax: (262) 334-5554
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 3952012 | Wisconsin |
Profile Details
| NPI number | 1801802947 |
|---|---|
| LBN Legal business name | Andersen, Travis J |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 31st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801802947 | NPPES |
| Wisconsin | MEDICAID | 38946400 |
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