Travis Campbell, P.T.
Individual provider Active NPI Physical Therapist · Glouster, OH
NPI 1386779593 · NPPES record last updated Aug 1, 2011
Key facts
- NPI
- 1386779593
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 9790 (OH)
- Practice address
- 22510 State Route 13
Glouster, OH 45732-9726 - Phone
- (740) 856-2017
- Fax
- (740) 767-2904
- NPI assigned
- Feb 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9790 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Ohio Sports Medicine and Physical Therapy | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9790 | OH | Yes |
Addresses
Primary practice location
22510 State Route 13
Glouster, OH 45732-9726
Mailing address
22510 State Route 13
Glouster, OH 45732-9726
Phone (740) 856-2017
Other providers in Glouster, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 1, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.