Individual
MR. NICHOLAS A AUSTIN
Active
Individual
MR. NICHOLAS A AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT, OCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004132
KY
2251X0800X
Orthopedic Physical Therapist
004132
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000484221
ANTHEM PROVIDER ID
KY
01
—
000000946564
BLUE CROSS BLUE SHIELD
KY
01
—
4132
KY STATE LICENSE
KY
05
—
7100392180
—
KY
01
—
9514
OCS CERTIFICATION
KY
Enumeration date
01/12/2007
Last updated
03/08/2017
Update your record
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