Healthcare Provider Details

I. General information

NPI: 1497184634
Provider Name (Legal Business Name): KRISTA JEAN SYLVESTER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2013
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 E BROAD ST
COLUMBUS OH
43213-1476
US

IV. Provider business mailing address

4511 HIDDEN RIDGE CT
GAHANNA OH
43230-4130
US

V. Phone/Fax

Practice location:
  • Phone: 614-575-9003
  • Fax: 614-575-9101
Mailing address:
  • Phone: 614-581-4291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number008084
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number008084
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: