Provider Demographics
NPI:1063613586
Name:SCHOCH, KRYSTAL (PT, DPT)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:
Last Name:SCHOCH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KRYSTAL
Other - Middle Name:
Other - Last Name:FOSMIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:15200 S JOG RD STE B8
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1246
Mailing Address - Country:US
Mailing Address - Phone:561-495-7171
Mailing Address - Fax:561-495-7138
Practice Address - Street 1:15200 S JOG RD STE B8
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-1246
Practice Address - Country:US
Practice Address - Phone:561-495-7171
Practice Address - Fax:561-495-7138
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT28109225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist