Individual
JUSTIN JOSEPH AGUSTINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
1324 N CHURCH ST, HAZLE TOWNSHIP, PA 18202-9307
(570) 501-1808
(855) 635-6308
Mailing address
255 MOUNTAIN VIEW DR, NANTICOKE, PA 18634-3603
(570) 814-7073
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RTO000178
PA
Other
Enumeration date
11/13/2013
Last updated
11/13/2013
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