Provider Demographics
NPI:1699315424
Name:TURNER, TRAVIS RAY (PHARMD)
Entity type:Individual
Prefix:
First Name:TRAVIS
Middle Name:RAY
Last Name:TURNER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 UNIVERSITY AVE.
Mailing Address - Street 2:A3 COLLEGE SQUARE MALL
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613
Mailing Address - Country:US
Mailing Address - Phone:319-266-9874
Mailing Address - Fax:
Practice Address - Street 1:6301 UNIVERSITY AVE.
Practice Address - Street 2:A3 COLLEGE SQUARE MALL
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613
Practice Address - Country:US
Practice Address - Phone:319-266-9874
Practice Address - Fax:319-266-3312
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20579183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist