White, John
White, John is an individual health care provider with primary practice located at 215 Se 2Nd Ave , Grand Rapids MN 55744-3615. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. White, John can be contacted via phone (218) 326-1274.Contact Information
Primary practice address
215 Se 2Nd Ave
Grand Rapids MN 55744-3615
Phone: (218) 326-1274
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X |
Profile Details
| NPI number | 1265822324 |
|---|---|
| LBN Legal business name | White, John |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 28th, 2015 |
| Last updated | Jan 28th, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265822324 | NPPES |
| Minnesota | MEDICAID | 894755400 |
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