Provider Demographics
NPI:1275714396
Name:SYLVESTER, DONNA H (PT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:H
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:DRUMRIGHT
Mailing Address - State:OK
Mailing Address - Zip Code:74030-3801
Mailing Address - Country:US
Mailing Address - Phone:918-352-3838
Mailing Address - Fax:918-352-2844
Practice Address - Street 1:115 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:DRUMRIGHT
Practice Address - State:OK
Practice Address - Zip Code:74030-3801
Practice Address - Country:US
Practice Address - Phone:918-352-3838
Practice Address - Fax:918-352-2844
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT1810225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist