Provider Demographics
NPI:1871944090
Name:SYLVESTER, TIFFANY MARIE (LMT)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:MARIE
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 BEULAH CIR APT 2
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1396
Mailing Address - Country:US
Mailing Address - Phone:907-301-7452
Mailing Address - Fax:
Practice Address - Street 1:541 W 36TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5804
Practice Address - Country:US
Practice Address - Phone:907-561-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist