Healthcare Provider Details

I. General information

NPI: 1134905789
Provider Name (Legal Business Name): KENDAL MARIE REED OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2023
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 569
CASTINE ME
04421-0569
US

IV. Provider business mailing address

PO BOX 569
CASTINE ME
04421-0569
US

V. Phone/Fax

Practice location:
  • Phone: 303-220-8089
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number10859TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: