Provider Demographics
NPI:1487270187
Name:SCHAUB, JESICA MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:JESICA
Middle Name:MARIE
Last Name:SCHAUB
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JESICA
Other - Middle Name:MARIE
Other - Last Name:STEELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:
Practice Address - Street 1:1410 S MAIN ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:KS
Practice Address - Zip Code:66067-3529
Practice Address - Country:US
Practice Address - Phone:785-242-2113
Practice Address - Fax:785-242-2116
Is Sole Proprietor?:No
Enumeration Date:2020-06-19
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021039388225100000X
KS11-06476225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist