Larson, John

Larson, John is an individual health care provider with primary practice located at 201 5Th St Nw Unit 790 , Watford City ND 58854-7118. He recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as his primary health care specialty. Larson, John can be contacted via phone (701) 444-3661.

Contact Information

Primary practice address
201 5Th St Nw Unit 790 Watford City ND 58854-7118
Phone: (701) 444-3661
Fax: (701) 444-6436
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1669098547
LBN Legal business name Larson, John
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2020
Last updated Jun 17th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669098547 NPPES
North Dakota MEDICAID 937374

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