Individual
MR. NICHOLAS A AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT, OCS
Contact information
Practice address
214 PARKER DR, SUITE B, LAGRANGE, KY 40031-1200
(502) 222-0280
(502) 222-0290
Mailing address
13415 FOREST SPRINGS DR, LOUISVILLE, KY 40245-2077
(502) 742-4825
(502) 222-0290
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
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