Provider Demographics
NPI:1811929581
Name:HOWARD, TRAVIS MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:MICHAEL
Last Name:HOWARD
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 1:4320 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4301
Mailing Address - Country:US
Mailing Address - Phone:812-299-7000
Mailing Address - Fax:812-299-7001
Practice Address - Street 1:4320 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4301
Practice Address - Country:US
Practice Address - Phone:812-299-7000
Practice Address - Fax:812-299-7001
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002091A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
248450AMedicare PIN
V11564Medicare UPIN