Provider Demographics
NPI:1124388558
Name:FELIX, TRAVIS DELL (DPT)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:DELL
Last Name:FELIX
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2561 S 1560 W UNIT B
Mailing Address - Street 2:
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84087-2361
Mailing Address - Country:US
Mailing Address - Phone:801-505-0821
Mailing Address - Fax:
Practice Address - Street 1:1030 S MEDICAL DR STE B
Practice Address - Street 2:
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-3281
Practice Address - Country:US
Practice Address - Phone:435-538-5111
Practice Address - Fax:435-538-5981
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8232792-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist