Provider Demographics
NPI:1164058376
Name:MCCORMACK, TRAVIS ARTHUR (MA ATC)
Entity Type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:ARTHUR
Last Name:MCCORMACK
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Gender:M
Credentials:MA ATC
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Mailing Address - Street 1:18815 CROSS COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-4612
Mailing Address - Country:US
Mailing Address - Phone:908-797-2530
Mailing Address - Fax:202-687-4117
Practice Address - Street 1:GEORGETOWN UNIVERSITY 37TH AND O ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20057-0001
Practice Address - Country:US
Practice Address - Phone:202-687-2362
Practice Address - Fax:202-687-4117
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer