Provider Demographics
NPI:1922626910
Name:SYLVEST, RONALD DANE II (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:DANE
Last Name:SYLVEST
Suffix:II
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5085 AMBER LEAF DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4281
Mailing Address - Country:US
Mailing Address - Phone:225-936-8292
Mailing Address - Fax:
Practice Address - Street 1:735 N MAIN ST STE 1300
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-2411
Practice Address - Country:US
Practice Address - Phone:770-580-8575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT014648225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist