Healthcare Provider Details

I. General information

NPI: 1548248149
Provider Name (Legal Business Name): JAY B KAIN PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 S MAIN ST
GREAT BARRINGTON MA
01230
US

IV. Provider business mailing address

PO BOX 926 789 S MAIN ST
GREAT BARRINGTON MA
01230
US

V. Phone/Fax

Practice location:
  • Phone: 413-528-0887
  • Fax: 413-528-6123
Mailing address:
  • Phone: 413-528-0887
  • Fax: 413-528-6123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TRACY COLLINS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 781-273-4125