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NPI Code Detail

MEDICARE: KRISTEN F SHETTLEWORTH PT

MEDICARE: KRISTEN F SHETTLEWORTH PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist17386MA
2225100000XPhysical Therapist007754CT

General Provider Information

NPI Number : 1285830042
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN F SHETTLEWORTH PT
Provider Business Mailing Address
First Line : 40 ORCHARD RD APT 3
Second Line :
City : BROOKLINE
State : MA
Zip : 02445-2152
Country : US
Telephone Number : 617-275-3946
Fax Number :
Provider Business Practice Location Address
First Line : 655 MAIN ST S
Second Line :
City : SOUTHBURY
State : CT
Zip : 06488-4220
Country : US
Telephone Number : 877-407-3422
Fax Number : 877-407-4329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2007
Last Update Date : 04/26/2025

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Directions to “ KRISTEN F SHETTLEWORTH PT” Practice Location

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