Provider Demographics
NPI:1962837054
Name:SHESKO, KRISTINA (DPT)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:SHESKO
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 1:3148 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:BOSWELL
Mailing Address - State:PA
Mailing Address - Zip Code:15531-2009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 CAMBRIDGE DR
Practice Address - Street 2:
Practice Address - City:DAVIDSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15928-9220
Practice Address - Country:US
Practice Address - Phone:814-288-2318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-07
Last Update Date:2013-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT010768L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist