Travis Shupe, PT | |
121 Advanced Technology Drive, Duffield, VA 24244 | |
(276) 431-7590 | |
(276) 461-7591 |
Full Name | Travis Shupe |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 11 Years |
Location | 121 Advanced Technology Drive, Duffield, Virginia |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760808075 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 9915 (Tennessee) | Secondary |
225100000X | Physical Therapist | 2305208564 (Virginia) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Holston Medical Group Pc | 8224935754 | 227 |
Provider Name | Holston Medical Group Pc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1831110667 PECOS PAC ID: 8224935754 Enrollment ID: O20040107000794 |
Mailing Address | Practice Location Address |
---|---|
Travis Shupe, PT Po Box 9, Kingsport, TN 37662-0009 Ph: (423) 857-2066 | Travis Shupe, PT 121 Advanced Technology Drive, Duffield, VA 24244 Ph: (276) 431-7590 |
Bernadine Gemma Aguirre, RPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 134 Cecil D Quillen Dr, Duffield, VA 24244 Phone: 276-431-3141 Fax: 276-431-3143 | |
Elizabeth Palabrica, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 157 Ross Carter Blvd, Duffield, VA 24244 Phone: 276-432-2841 | |
Stephanie Rose Miller, RPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 134 Cecil D Quillen Dr, Duffield, VA 24244 Phone: 276-431-3141 |