Provider Demographics
NPI:1588966790
Name:SLETTEN, MARVA KAY (PT)
Entity type:Individual
Prefix:MRS
First Name:MARVA
Middle Name:KAY
Last Name:SLETTEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 PECK AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-3124
Mailing Address - Country:US
Mailing Address - Phone:239-482-8384
Mailing Address - Fax:866-728-6060
Practice Address - Street 1:660 PECK AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-3124
Practice Address - Country:US
Practice Address - Phone:239-482-8384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT5843225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist