JOHN WALLACE REAVIS

FARGO, ND
NPI1750446845
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: ND  3411)
Enumeration Date2006-12-27
Last Update Date2007-07-08
Business Address
JOHN WALLACE REAVIS
1532 32ND AVE S
FARGO, ND 58103-5987
Phone number: 701-280-1928
Mailing Address
JOHN WALLACE REAVIS
3319 18TH ST S
FARGO, ND 58104-6537
Phone number: 701-232-7589
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