Provider Demographics
NPI:1891986196
Name:BACHERT, TRAVIS R (DC, FIAMA)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:R
Last Name:BACHERT
Suffix:
Gender:M
Credentials:DC, FIAMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 W POPLAR ST.
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756
Mailing Address - Country:US
Mailing Address - Phone:479-631-7300
Mailing Address - Fax:479-631-7306
Practice Address - Street 1:1110 W POPLAR ST
Practice Address - Street 2:SUITE B
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756
Practice Address - Country:US
Practice Address - Phone:479-631-7300
Practice Address - Fax:479-631-7306
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1580111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition