Provider Demographics
NPI:1710234224
Name:SELLERS, TRAVIS DEE (DPT)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:DEE
Last Name:SELLERS
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 1:19122 E KINGBIRD DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-5328
Mailing Address - Country:US
Mailing Address - Phone:208-313-7687
Mailing Address - Fax:
Practice Address - Street 1:4365 E PECOS RD
Practice Address - Street 2:STE 125
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-8052
Practice Address - Country:US
Practice Address - Phone:480-550-6660
Practice Address - Fax:480-867-1695
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ99532251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic