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General NPI Number Information
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NPI Number | 1285830042
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Entity Type | Individual
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Provider Name | KRISTEN F SHETTLEWORTH PT
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Gender | Female
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 04/26/2025
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Provider Practice Location Address
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Address Line | 655 MAIN ST S
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City | SOUTHBURY
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State | CT
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Zip | 06488-4220
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Country | US
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Telephone | 877-407-3422
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Fax | 877-407-4329
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Provider Business Mailing Address
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Address Line | 40 ORCHARD RD APT 3
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City | BROOKLINE
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State | MA
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Zip | 02445-2152
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Country | US
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Telephone | 617-275-3946
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 17386
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 007754
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License Number State | CT
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