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General NPI Number Information
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NPI Number | 1295760643
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Entity Type | Individual
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Provider Name | AMY LYNN REIS OD
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 2250 N DIERS AVE
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City | GRAND ISLAND
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State | NE
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Zip | 68803
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Country | US
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Telephone | 308-381-4797
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Fax | 308-381-5820
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Provider Business Mailing Address
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Address Line | 201 M ST
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City | LOUP CITY
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State | NE
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Zip | 68853-8031
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Country | US
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Telephone | 308-381-4797
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Fax | 308-381-5820
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1077
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License Number State | NE
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