Basic Information
| Provider Information | |||||||||
| NPI: | 1689799595 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REID | ||||||||
| FirstName: | KRISTA | ||||||||
| MiddleName: | MUNSELL | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 INDIAN TRL S | ||||||||
| Address2: | |||||||||
| City: | WAKEFIELD | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028791925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014801854 | ||||||||
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| Practice Location | |||||||||
| Address1: | 730 KINGSTOWN RD | ||||||||
| Address2: | OLYMPIC PHYSICAL THERAPY | ||||||||
| City: | WAKEFIELD | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02879 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4012843424 | ||||||||
| FaxNumber: | 4016193752 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2007 | ||||||||
| LastUpdateDate: | 09/19/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT1225 | RI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.