Provider Demographics
NPI:1184663593
Name:TRAVIS, ARTHUR W (DC)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:W
Last Name:TRAVIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 FOULK RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3634
Mailing Address - Country:US
Mailing Address - Phone:302-475-1267
Mailing Address - Fax:302-475-7751
Practice Address - Street 1:1911 FOULK RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-3634
Practice Address - Country:US
Practice Address - Phone:302-475-1267
Practice Address - Fax:302-475-7751
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF10000352111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE486409Medicare ID - Type Unspecified