Provider Demographics
NPI:1972327898
Name:SIZEMORE, JESSICA RENE (DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RENE
Last Name:SIZEMORE
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 1:117 EASTWIND CT
Mailing Address - Street 2:
Mailing Address - City:HAWESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42348-6736
Mailing Address - Country:US
Mailing Address - Phone:270-927-9229
Mailing Address - Fax:
Practice Address - Street 1:117 EASTWIND CT
Practice Address - Street 2:
Practice Address - City:HAWESVILLE
Practice Address - State:KY
Practice Address - Zip Code:42348-6736
Practice Address - Country:US
Practice Address - Phone:270-927-9229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05015432A225100000X
KY006060225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist