Individual
MR. BRAYDON AUGUSTINOVICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
651 E 191ST ST, WESTFIELD, IN 46074-9243
(317) 922-1990
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258
(586) 350-2644
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003644A
IN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/29/2020
Last updated
02/05/2025
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