Provider Demographics
NPI:1710423140
Name:TOURJEE, TRAVIS (DC)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:
Last Name:TOURJEE
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 1:4990 LAKESHORE RD
Mailing Address - Street 2:
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-3539
Mailing Address - Country:US
Mailing Address - Phone:419-604-9846
Mailing Address - Fax:
Practice Address - Street 1:2856 KRAFFT RD
Practice Address - Street 2:
Practice Address - City:FORT GRATIOT
Practice Address - State:MI
Practice Address - Zip Code:48059-3944
Practice Address - Country:US
Practice Address - Phone:810-385-8450
Practice Address - Fax:810-385-4115
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010484111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor