Provider Demographics
NPI:1205434131
Name:HUGHES, TRAVIS (DPT)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:
Last Name:HUGHES
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 1:19 SHELTER LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19055-2008
Mailing Address - Country:US
Mailing Address - Phone:267-269-4429
Mailing Address - Fax:
Practice Address - Street 1:1 E TRENTON AVE # STORE8A
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067-1004
Practice Address - Country:US
Practice Address - Phone:215-295-4538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT028826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist