Provider Demographics
NPI:1629367305
Name:AUGUSTINE, FRANK WILLIAM (OTR)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:WILLIAM
Last Name:AUGUSTINE
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 RIVERBEND DR
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-9785
Mailing Address - Country:US
Mailing Address - Phone:843-299-0342
Mailing Address - Fax:843-299-0342
Practice Address - Street 1:88 RIVERBEND DR
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-9785
Practice Address - Country:US
Practice Address - Phone:843-299-0342
Practice Address - Fax:843-299-0342
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000274-1225X00000X
SC3637225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist