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NPI Code Detail

MEDICARE: MR. JOHN EDWARD AUSTIN OTR/L,CHT

MEDICARE:  MR. JOHN EDWARD AUSTIN  OTR/L,CHT
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
1225XH1200XHand Occupational Therapist2163SC

General Provider Information

NPI Number : 1568658540
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN EDWARD AUSTIN OTR/L,CHT
Provider Business Mailing Address
First Line : 2125 CHARLIE HALL BLVD
Second Line : DEPT. OF OT/PT
City : CHARLESTON
State : SC
Zip : 29414-5879
Country : US
Telephone Number : 843-573-1513
Fax Number : 843-573-1511
Provider Business Practice Location Address
First Line : 2125 CHARLIE HALL BLVD
Second Line : DEPT. OF OT/PT
City : CHARLESTON
State : SC
Zip : 29414-5879
Country : US
Telephone Number : 843-573-1513
Fax Number : 843-573-1511
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2007
Last Update Date : 09/24/2007

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Directions to “ MR. JOHN EDWARD AUSTIN OTR/L,CHT” Practice Location

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