| Travis Scott Burch | |
|
1040 Crater Lake Ave Ste D Medford OR 97504-6295 | |
| (541) 613-1220 | |
| Not Available |
| Full Name | Travis Scott Burch |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1040 Crater Lake Ave Ste D, Medford, Oregon |
| Authorized Official Name and Position | Melynda Owens (BILLING & CREDENTIALING MANAGER) |
| Authorized Official Contact | 5415008655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Travis Scott Burch Po Box 4752 Medford OR 97501-0197 Ph: (541) 500-8655 | Travis Scott Burch 1040 Crater Lake Ave Ste D Medford OR 97504-6295 Ph: (541) 613-1220 |
| NPI Number | 1992339816 |
|---|---|
| Provider Enumeration Date | 02/29/2020 |
| Last Update Date | 02/29/2020 |
| Certification Date | 02/29/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992339816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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