Individual
DR. TRAVIS EUGENE STALLBAUMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1600 COMMUNITY DR, SENECA, KS 66538-9739
(785) 336-6181
Mailing address
1113 RIVER BLUFFS RD, SENECA, KS 66538-2636
(785) 548-5371
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13515
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13515
PHARMACY LICENSE NUMBER
KS
Enumeration date
05/30/2007
Last updated
10/22/2020
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