Individual
MARK AUGUSTAUSKAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
21 HOLLEY LN, 93 WATERBURY RD., PROSPECT, CT 06712-1484
(203) 758-6569
(203) 758-0443
Mailing address
21 HOLLEY LANE, PROSPECT, CT 06712
(203) 758-6569
(203) 758-0443
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
002427
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002427
STATE LICENSE, PHYSICAL T
CT
Enumeration date
07/08/2005
Last updated
11/08/2010
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