Individual
CHRISTIE KENNEDY AUGUSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
308 BRYNN MARR RD, JACKSONVILLE, NC 28546-7023
(910) 478-9701
Mailing address
HC 6 BOX 6046, HAWLEY, PA 18428-9100
(570) 226-5680
(570) 226-5682
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P19468
NC
225100000X
Physical Therapist
PT008630L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
819136
1ST PRIO-MOTION
—
01
—
819229
1ST PRIO-NOLIMITS
—
01
—
842948
MPN
—
01
—
9373970
PHCS
—
01
—
AU1693421
BLUE SHIELD
—
01
—
PT00863OL
LIC #
—
Enumeration date
08/30/2005
Last updated
05/15/2020
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