Provider Demographics
NPI:1700960317
Name:KAHRE, TRAVIS WADE (DC)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:WADE
Last Name:KAHRE
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 1:3333 IRVIN COBB DR STE 104
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-0526
Mailing Address - Country:US
Mailing Address - Phone:270-442-2211
Mailing Address - Fax:270-933-1054
Practice Address - Street 1:3333 IRVIN COBB DR STE 104
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-0526
Practice Address - Country:US
Practice Address - Phone:270-442-2211
Practice Address - Fax:270-933-1054
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY85003093Medicaid
KY85003093Medicaid
KY01123001Medicare PIN