Individual
TRAVIS STARGARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
509 UNIVERSITY DR., EAU CLAIRE, WI 54701
(715) 836-2022
Mailing address
PO BOX 1363, EAU CLAIRE, WI 54702-1363
(715) 305-6081
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
WI
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UNKNOWN
N/A
WI
Enumeration date
03/20/2018
Last updated
03/20/2018
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