Individual
MR. ROBERT P. AUGUSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
210 E DERENNE AVE, ATTN: PROVIDER ENROLLMENT, SAVANNAH, GA 31405-6736
(912) 644-5300
(912) 644-5260
Mailing address
210 E DERENNE AVE, SAVANNAH, GA 31405-6736
(912) 644-5300
(912) 644-5260
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT004313
GA
225X00000X
Occupational Therapist
OT14437
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101362237A
—
GA
Enumeration date
05/10/2006
Last updated
10/21/2015
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