Provider Demographics
NPI:1619544509
Name:SYLVESTER, CHARLOTTE CARMEL (PT, DPT, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:CARMEL
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:PT, DPT, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2498 JOINER CT
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-4912
Mailing Address - Country:US
Mailing Address - Phone:954-592-3324
Mailing Address - Fax:
Practice Address - Street 1:2498 JOINER CT
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4912
Practice Address - Country:US
Practice Address - Phone:954-592-3324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0036552255A2300X
GAPT015910225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer