MEDICARE: PILATES DPT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1720702889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PILATES DPT LLC

Provider Business Mailing Address
First Line	:	5 DINO RD
Second Line	:
City	:	WAREHAM
State	:	MA
Zip	:	02571-2422
Country	:	US
Telephone Number	:	774-454-3664
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 FALMOUTH HEIGHTS RD
Second Line	:
City	:	FALMOUTH
State	:	MA
Zip	:	02540-3660
Country	:	US
Telephone Number	:	774-454-3664
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KRISTIN ELIZABETH SMEAD
Credential	:	PT, DPT
Telephone Number	:	774-454-3664

Provider Enumeration Date	:	10/03/2022
Last Update Date	:	10/03/2022

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