Provider Demographics
NPI:1699720839
Name:SAYLOR-PAVKOVICH, ESTELLE ATHALENE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ESTELLE
Middle Name:ATHALENE
Last Name:SAYLOR-PAVKOVICH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ESTELLE
Other - Middle Name:ATHALENE
Other - Last Name:SAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MSPT
Mailing Address - Street 1:175 W LOWRY LN
Mailing Address - Street 2:STE 112
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3012
Mailing Address - Country:US
Mailing Address - Phone:859-744-0036
Mailing Address - Fax:859-744-0041
Practice Address - Street 1:404 SHOPPERS DRIVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391
Practice Address - Country:US
Practice Address - Phone:859-744-0036
Practice Address - Fax:859-744-0041
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT-0044062251X0800X
KY004406225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100216410Medicaid
KY7100216410Medicaid
KYK058920Medicare PIN