Healthcare Provider Details

I. General information

NPI: 1669219044
Provider Name (Legal Business Name): KRISTEN ABSALON DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 SEA ISLAND PKWY STE 103
BEAUFORT SC
29907-1499
US

IV. Provider business mailing address

108 CRESTVIEW LN
BLUFFTON SC
29910-7928
US

V. Phone/Fax

Practice location:
  • Phone: 843-379-3991
  • Fax:
Mailing address:
  • Phone: 513-532-0773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number12862
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: