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NPI Code Detail

MEDICARE: MS. KRISTEN L PEASE PT, DPT

MEDICARE: MS. KRISTEN L PEASE PT, DPT
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 TherapistPT3569ME

General Provider Information

NPI Number : 1932330719
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTEN L PEASE PT, DPT
Provider Business Mailing Address
First Line : PO BOX 48
Second Line :
City : CORNISH
State : ME
Zip : 04020-0048
Country : US
Telephone Number : 207-625-4300
Fax Number : 207-625-7300
Provider Business Practice Location Address
First Line : 16 OLD PIKE RD
Second Line :
City : CORNISH
State : ME
Zip : 04020-3506
Country : US
Telephone Number : 207-625-4300
Fax Number : 207-625-7300
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2009
Last Update Date : 07/26/2021

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