Healthcare Provider Details

I. General information

NPI: 1639778087
Provider Name (Legal Business Name): KRISTIN ELIZABETH SMEAD DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN ELIZABETH SMEAD DPT

II. Dates (important events)

Enumeration Date: 10/17/2020
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 SERVICE RD 311 SERVICE ROAD
EAST SANDWICH MA
02537-1370
US

IV. Provider business mailing address

311 SERVICE RD
EAST SANDWICH MA
02537-1370
US

V. Phone/Fax

Practice location:
  • Phone: 508-833-4000
  • Fax:
Mailing address:
  • Phone: 508-833-4000
  • Fax: 508-833-4000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25182
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: