Travis Banks, OTR/L

Individual provider Active NPI Occupational Therapist · Layton, UT

NPI 1992287221 · NPPES record last updated Sep 4, 2018

Key facts

NPI
1992287221
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
10962470-4201 (UT)
Practice address
1992 W Antelope Dr Ste 1D
Layton, UT 84041-4974
Phone
(801) 773-2633
NPI assigned
Sep 4, 2018
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
10962470-4201UTMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 10962470-4201 UT Yes

Addresses

Primary practice location

1992 W Antelope Dr Ste 1D
Layton, UT 84041-4974

Mailing address

3681 S 2000 E Apt 2
Salt Lake City, UT 84109-4319
Phone (435) 659-7552

Other providers in Layton, UT

All providers in Layton, UT · Occupational Therapist in Utah

Sources for this page

Verify at the official NPI Registry.