Individual
DR. JUSTIN TYLER REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
605 S BROADWAY ST, PORTLAND, TN 37148-1619
(615) 636-8671
Mailing address
402 RANCH RD, PORTLAND, TN 37148-5367
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3752
TN
Other
Enumeration date
06/22/2022
Last updated
06/12/2024
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