Provider Demographics
NPI:1922461870
Name:DEUSNER, ELISSA (PT DPT)
Entity Type:Individual
Prefix:DR
First Name:ELISSA
Middle Name:
Last Name:DEUSNER
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 WINCHESTER RD N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-6314
Mailing Address - Country:US
Mailing Address - Phone:812-455-0627
Mailing Address - Fax:
Practice Address - Street 1:1311 WINCHESTER RD N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-6314
Practice Address - Country:US
Practice Address - Phone:812-455-0627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT27451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist