Reavis, John Wallace

Reavis, John Wallace is an sole proprietor health care provider with primary practice located at 1532 32Nd Ave S , Fargo ND 58103-5987. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Reavis, John Wallace can be contacted via phone (701) 280-1928.

Contact Information

Primary practice address
1532 32Nd Ave S Fargo ND 58103-5987
Fax: (701) 280-1402
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 3411 North Dakota

Profile Details

NPI number 1750446845
LBN Legal business name Reavis, John Wallace
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 27th, 2006
Last updated Jul 8th, 2007 - about 17 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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