Provider Demographics
NPI:1720346364
Name:AUGUSTIN, CHRISTIAN RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:RICHARD
Last Name:AUGUSTIN
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 1:8335 GAYFER ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-3051
Mailing Address - Country:US
Mailing Address - Phone:251-990-8388
Mailing Address - Fax:251-650-1599
Practice Address - Street 1:8335 GAYFER ROAD EXT
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-3051
Practice Address - Country:US
Practice Address - Phone:251-990-8388
Practice Address - Fax:251-650-1599
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2114111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor