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General NPI Number Information
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NPI Number | 1841341047
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Entity Type | Organization
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Legal Business Name | JOHN W. REIS
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 724 ALLEN ST
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City | BOONE
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State | IA
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Zip | 50036-2929
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Country | US
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Telephone | 515-432-8534
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Fax | 515-432-8631
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Provider Business Mailing Address
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Address Line | 724 ALLEN ST
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City | BOONE
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State | IA
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Zip | 50036-2929
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Country | US
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Telephone | 515-432-8534
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Fax | 515-432-8631
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Authorized Official
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Title or Position | AUDIOLOGIST, OWNER
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Name | MR. JOHN W REIS
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Credential | AU.D.
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Telephone | 515-432-8534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 00508
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License Number State | IA
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