Provider Demographics
NPI:1831570969
Name:CARIGNAN, TRAVIS JAMES (MS, ATC)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:JAMES
Last Name:CARIGNAN
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 MAIN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2620
Mailing Address - Country:US
Mailing Address - Phone:774-240-5475
Mailing Address - Fax:207-783-0019
Practice Address - Street 1:30 BELGRADE AVE STE A
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-4096
Practice Address - Country:US
Practice Address - Phone:207-783-0018
Practice Address - Fax:207-783-0019
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2023-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAT5312255A2300X
NH06312255A2300X
MA24372255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer