Basic Information
| Provider Information | |||||||||
| NPI: | 1295463305 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AARDSMA | ||||||||
| FirstName: | TRAVIS | ||||||||
| MiddleName: | JON | ||||||||
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| Credential: | RRT-NPS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13414 S CHEYENNE CT | ||||||||
| Address2: | |||||||||
| City: | PINE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 804709562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3036531174 | ||||||||
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| Practice Location | |||||||||
| Address1: | 13123 E 16TH AVE | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800457106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7207771234 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2022 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2278P3900X | RTL.0005093 | CO | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Neonatal/Pediatrics | 2279P3900X | RTL.0005093 | CO | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Neonatal/Pediatrics |
No ID Information.