Provider Demographics
NPI:1376724344
Name:SHARON LEE REED
Entity Type:Organization
Organization Name:SHARON LEE REED
Other - Org Name:PROFESSIONAL FITTINGS BY SHARON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CERTIFIED MASTECTOMY FITTER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-922-5982
Mailing Address - Street 1:2615 HAMMOND HIGHLANDS DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-9141
Mailing Address - Country:US
Mailing Address - Phone:231-922-5982
Mailing Address - Fax:231-922-5982
Practice Address - Street 1:2615 HAMMOND HIGHLANDS DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-9141
Practice Address - Country:US
Practice Address - Phone:231-922-5982
Practice Address - Fax:231-922-5982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI33332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540D50256OtherBCBSM
MI540D50256OtherBCBSM