Provider Demographics
NPI:1609057702
Name:KEANE, KRISTEN M (MSPT)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:KEANE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 WATER ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3208
Mailing Address - Country:US
Mailing Address - Phone:508-433-4478
Mailing Address - Fax:508-319-3102
Practice Address - Street 1:747 WATER ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-3208
Practice Address - Country:US
Practice Address - Phone:508-433-4478
Practice Address - Fax:508-319-3102
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10025225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist