Travis Ray Green, PA-C
NPI #1134693518 in Bloomington, Minnesota
Provider Information
- NPI Number
- 1134693518
- Entity Type
- Individual
- Name
- Travis Ray Green, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Jan 18, 2019
- Last Updated
- Oct 18, 2023
Practice Location
- Address
- 4300 MARKET PTE DR STE 100
- City
- Bloomington
- State
- Minnesota
- ZIP Code
- 55435-5435
- Phone
- (952) 767-4574
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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