Provider Demographics
NPI:1679662944
Name:KRAMER, TRAVIS JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:JOHN
Last Name:KRAMER
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 1:815 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-1856
Mailing Address - Country:US
Mailing Address - Phone:320-760-6531
Mailing Address - Fax:218-338-2493
Practice Address - Street 1:815 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-1856
Practice Address - Country:US
Practice Address - Phone:320-760-6531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4517111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN05100300201OtherPRIME WEST ID
MNP00249245OtherRAILROAD MEDICARE
MN051003002OtherPRIME WEST ID
MN258L4KROtherBC/BS PROVIDER ID
MN305420900OtherMHCP PROVIDER ID
MNC03989OtherGROUP NUMBER
MNU99402Medicare UPIN
MN051003002OtherPRIME WEST ID