Individual
TRAVIS RYAN KOOIMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1714 FAIR PHEASANT WAY, SUN PRAIRIE, WI 53590-9419
(712) 470-6699
Mailing address
4109 S GRAND SLAM PL APT 10, SIOUX FALLS, SD 57110-4850
(712) 470-6699
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
81468
WI
Other
Enumeration date
04/02/2021
Last updated
05/04/2023
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