Provider Demographics
NPI:1497184634
Name:SYLVESTER, KRISTA JEAN (PT)
Entity Type:Individual
Prefix:MS
First Name:KRISTA
Middle Name:JEAN
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 1:4511 HIDDEN RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4130
Mailing Address - Country:US
Mailing Address - Phone:614-581-4291
Mailing Address - Fax:
Practice Address - Street 1:5500 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-1476
Practice Address - Country:US
Practice Address - Phone:614-575-9003
Practice Address - Fax:614-575-9101
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH008084225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics