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General NPI Number Information
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NPI Number | 1649320250
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Entity Type | Individual
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Provider Name | NICHOLAS A AUSTIN MSPT, OCS
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Gender | Male
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 03/08/2017
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Provider Practice Location Address
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Address Line | 214 PARKER DR SUITE B
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City | LAGRANGE
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State | KY
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Zip | 40031-1200
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Country | US
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Telephone | 502-222-0280
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Fax | 502-222-0290
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Provider Business Mailing Address
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Address Line | 13415 FOREST SPRINGS DR
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City | LOUISVILLE
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State | KY
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Zip | 40245-2077
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Country | US
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Telephone | 502-742-4825
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Fax | 502-222-0290
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 004132
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 004132
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License Number State | KY
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