Provider Demographics
NPI:1497061360
Name:INSCHO, JESSICA ALAINE (DPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ALAINE
Last Name:INSCHO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 59TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-8539
Mailing Address - Country:US
Mailing Address - Phone:727-302-3751
Mailing Address - Fax:727-345-3957
Practice Address - Street 1:12416 66TH ST STE A
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-3430
Practice Address - Country:US
Practice Address - Phone:277-547-4700
Practice Address - Fax:727-394-8661
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-29
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 25811225100000X
FLPT25811261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist