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NPI Code Detail

MEDICARE: BIBIN K AUGUSTINE PT, DPT

MEDICARE: BIBIN K AUGUSTINE PT, DPT
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
1225100000XPhysical Therapist15683-24WI

General Provider Information

NPI Number : 1215697099
Entity Type Code : Individual
Provider Name (Legal Business Name) : BIBIN K AUGUSTINE PT, DPT
Provider Business Mailing Address
First Line : 1271 N 6TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3360
Country : US
Telephone Number : 414-978-9100
Fax Number : 414-978-9139
Provider Business Practice Location Address
First Line : 1271 N 6TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-3360
Country : US
Telephone Number : 414-978-9100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2021
Last Update Date : 02/04/2026

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