Individual
TINA REIDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1021 OAK FOREST LN, MYRTLE BEACH, SC 29577-9795
(774) 930-0260
Mailing address
2326 LARK SPARROW ST, MYRTLE BEACH, SC 29577-1538
(774) 930-0260
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1377
SC
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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