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NPI Code Detail

MEDICARE: DAVID L AUSTIN PTA

MEDICARE: DAVID L AUSTIN PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant25071FL

General Provider Information

NPI Number : 1417421181
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID L AUSTIN PTA
Provider Business Mailing Address
First Line : 7801 POINT MEADOWS DR UNIT 3403
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-9149
Country : US
Telephone Number : 904-710-2451
Fax Number :
Provider Business Practice Location Address
First Line : 7723 JASPER AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-7719
Country : US
Telephone Number : 904-725-8044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2019
Last Update Date : 01/16/2019

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