Individual
TREY REID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2940 DERR RD APT 221, SPRINGFIELD, OH 45503-7007
(937) 460-1958
Mailing address
2940 DERR RD APT 22145503, SPRINGFIELD, OH 45503-7004
(937) 460-1958
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119489132
—
OH
Enumeration date
01/20/2022
Last updated
01/20/2022
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