| Doctor Name: | TRAVIS SHUPE |
| NPI Number: | 1760808075 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 9915 |
| Business Practice Address: | 121 Advanced Technology Drive Duffield, VA - 24244 |
| Business Phone Number: | 2764317590 |
| Business Fax Number: | 2764617591 |
| Mailing Address: | Po Box 9, KINGSPORT |
| State: | TN |
| Postal Code: | 376620009 |
| Phone Number: | 4238572066 |
| Fax Number: | 4238572070 |
| NPI Enumeration Date: | 03/11/2014 |
| NPI Last Update Date: | 03/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 9915 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |