Healthcare Provider Details

I. General information

NPI: 1982536371
Provider Name (Legal Business Name): TIERRA LIN KASTNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 CHESTNUT ST
SAUGUS MA
01906-1605
US

IV. Provider business mailing address

300 COUNTY ROAD 371
BONO AR
72416-7643
US

V. Phone/Fax

Practice location:
  • Phone: 781-233-8123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA4508
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA28101
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: