Provider Demographics
NPI:1336942119
Name:RIOS, JESSICA JANE (LMT)
Entity type:Individual
Prefix:
First Name:JESSICA JANE
Middle Name:
Last Name:RIOS
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 E TWOHIG AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-6441
Mailing Address - Country:US
Mailing Address - Phone:325-340-2720
Mailing Address - Fax:
Practice Address - Street 1:36 E TWOHIG AVE STE 108
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-6441
Practice Address - Country:US
Practice Address - Phone:325-340-2720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist