Provider Demographics
NPI:1831408012
Name:OXENTENKO, SHARON EILEEN (MS)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:EILEEN
Last Name:OXENTENKO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SANITARIUM CIR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-4635
Mailing Address - Country:US
Mailing Address - Phone:423-775-0771
Mailing Address - Fax:
Practice Address - Street 1:200 SANITARIUM CIR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-4635
Practice Address - Country:US
Practice Address - Phone:423-775-0771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT0000008620225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist