MEDICARE: JARED ALLEN 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
1	225100000X	Physical Therapist	PT04003	RI

General Provider Information

NPI Number	:	1316837784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARED ALLEN PT

Provider Business Mailing Address
First Line	:	703 GRANITE ST STE 3
Second Line	:
City	:	BRAINTREE
State	:	MA
Zip	:	02184-5350
Country	:	US
Telephone Number	:	781-807-6138
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 RESERVOIR AVE
Second Line	:
City	:	CRANSTON
State	:	RI
Zip	:	02910-4426
Country	:	US
Telephone Number	:	401-946-4250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2025
Last Update Date	:	07/08/2025

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