Individual
TRAVIS JOHN LA BARRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
130 2ND ST, NEENAH, WI 54956-2883
(920) 420-6189
Mailing address
1631 S VAN DYKE RD, APPLETON, WI 54914-8269
(920) 420-6189
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
13282-33
WI
Other
Enumeration date
11/22/2022
Last updated
11/22/2022
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