Provider Demographics
NPI:1083095830
Name:REED, TYREL (DPT)
Entity Type:Individual
Prefix:
First Name:TYREL
Middle Name:
Last Name:REED
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 W 6TH ST STE 124
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2249
Mailing Address - Country:US
Mailing Address - Phone:785-843-9125
Mailing Address - Fax:
Practice Address - Street 1:1112 W 6TH ST STE 124
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2249
Practice Address - Country:US
Practice Address - Phone:785-843-9125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist