Provider Demographics
NPI:1205582855
Name:AISPORNA, JO ELAINE ROCHELLE MILO (DPT)
Entity type:Individual
Prefix:
First Name:JO ELAINE ROCHELLE
Middle Name:MILO
Last Name:AISPORNA
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 1:31019 ROSE ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-7139
Mailing Address - Country:US
Mailing Address - Phone:951-436-8064
Mailing Address - Fax:
Practice Address - Street 1:31019 ROSE ARBOR CT
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-7139
Practice Address - Country:US
Practice Address - Phone:951-436-8064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT299971225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty