Provider Demographics
NPI:1366823908
Name:COMISKEY, JESSICA (DPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:COMISKEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1076 W CHANDLER BLVD
Mailing Address - Street 2:103
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5225
Mailing Address - Country:US
Mailing Address - Phone:480-821-1997
Mailing Address - Fax:408-782-5213
Practice Address - Street 1:1076 W CHANDLER BLVD
Practice Address - Street 2:103
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5225
Practice Address - Country:US
Practice Address - Phone:480-821-1997
Practice Address - Fax:408-782-5213
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11539225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist