Provider Demographics
NPI:1578061305
Name:AUGELLO, WILLIAM GERARD (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GERARD
Last Name:AUGELLO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12604 S BROUGHAM DR
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-5249
Mailing Address - Country:US
Mailing Address - Phone:661-860-9788
Mailing Address - Fax:
Practice Address - Street 1:8403 BALM ST
Practice Address - Street 2:
Practice Address - City:WEEKI WACHEE
Practice Address - State:FL
Practice Address - Zip Code:34607
Practice Address - Country:US
Practice Address - Phone:352-340-5936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-26
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-05874111N00000X
FLCH12851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor