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Individual

DAVID TODD TRAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
302 E. AVE. A, SYRACUSE, KS 67878
(620) 384-7424
(620) 384-7424
Mailing address
PO BOX 157, 712 N. GATES ST., SYRACUSE, KS 67878-0157
(620) 384-5734
(620) 384-7424

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-11847
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-11847
PHARMACIST LICENSE
KS
Enumeration date
07/06/2006
Last updated
07/08/2007
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