Provider Demographics
NPI:1407219991
Name:SYLVESTER, ANDREA (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 RAMSEY ST
Mailing Address - Street 2:#600
Mailing Address - City:SHAKOPEE
Mailing Address - State:MN
Mailing Address - Zip Code:55379-3133
Mailing Address - Country:US
Mailing Address - Phone:952-977-9933
Mailing Address - Fax:
Practice Address - Street 1:1275 RAMSEY STREET SOUTH
Practice Address - Street 2:#600
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379
Practice Address - Country:US
Practice Address - Phone:952-977-9933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6177111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor