Provider Demographics
NPI:1346539657
Name:LAMPERSKI, TRAVIS ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:ROBERT
Last Name:LAMPERSKI
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 1:5500 S STATE ROAD 7
Mailing Address - Street 2:SUITE 112
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33449-5451
Mailing Address - Country:US
Mailing Address - Phone:561-708-5700
Mailing Address - Fax:561-708-5750
Practice Address - Street 1:5500 S STATE ROAD 7
Practice Address - Street 2:SUITE 112
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33449-5451
Practice Address - Country:US
Practice Address - Phone:561-708-5700
Practice Address - Fax:561-708-5750
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10755111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGT840YMedicare PIN