Provider Demographics
NPI:1568658540
Name:AUSTIN, JOHN EDWARD (OTR/L,CHT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:EDWARD
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:OTR/L,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 CHARLIE HALL BLVD
Mailing Address - Street 2:DEPT. OF OT/PT
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5879
Mailing Address - Country:US
Mailing Address - Phone:843-573-1513
Mailing Address - Fax:843-573-1511
Practice Address - Street 1:2125 CHARLIE HALL BLVD
Practice Address - Street 2:DEPT. OF OT/PT
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5879
Practice Address - Country:US
Practice Address - Phone:843-573-1513
Practice Address - Fax:843-573-1511
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2163225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand