Provider Demographics
NPI:1023422789
Name:COLE, SYDNIE SHACKLETON (PT, DPT)
Entity type:Individual
Prefix:
First Name:SYDNIE
Middle Name:SHACKLETON
Last Name:COLE
Suffix:
Gender:F
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 1:1805 COLLEGE DR
Mailing Address - Street 2:OTHER ADDRESS
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-1919
Mailing Address - Country:US
Mailing Address - Phone:225-923-3420
Mailing Address - Fax:225-922-9316
Practice Address - Street 1:1805 COLLEGE DR
Practice Address - Street 2:OTHER ADDRESS
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-1919
Practice Address - Country:US
Practice Address - Phone:225-923-3420
Practice Address - Fax:225-922-9316
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist