Healthcare Provider Details

I. General information

NPI: 1699720839
Provider Name (Legal Business Name): ESTELLE ATHALENE SAYLOR-PAVKOVICH PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ESTELLE ATHALENE SAYLOR PT, MSPT

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 10/14/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 SHOPPERS DRIVE
WINCHESTER KY
40391
US

IV. Provider business mailing address

175 W LOWRY LN STE 112
LEXINGTON KY
40503-3012
US

V. Phone/Fax

Practice location:
  • Phone: 859-744-0036
  • Fax: 859-744-0041
Mailing address:
  • Phone: 859-744-0036
  • Fax: 859-744-0041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004406
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT-004406
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: