Individual
KAITLIN LIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
10 SHADOW RIDGE DR, RICHMOND, RI 02812-1115
(401) 213-6529
Mailing address
10 SHADOW RIDGE DR, RICHMOND, RI 02812-1115
(401) 213-6529
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
010363
CT
225100000X
Physical Therapist
Primary
PT02711
RI
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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