Healthcare Provider Details

I. General information

NPI: 1114386992
Provider Name (Legal Business Name): KAREN SMITH PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAREN FRANKNECHT

II. Dates (important events)

Enumeration Date: 02/22/2016
Last Update Date: 02/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 NORTH ST APT 2
HINGHAM MA
02043-2234
US

IV. Provider business mailing address

38 NORTH ST APT 2
HINGHAM MA
02043-2234
US

V. Phone/Fax

Practice location:
  • Phone: 732-319-2376
  • Fax:
Mailing address:
  • Phone: 732-319-2376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number21095
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: