Individual
ELIZABETH MABLE AUGUSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
101 S LA CANADA DR # 47, GREEN VALLEY, AZ 85614-2603
(520) 207-9345
(520) 207-9345
Mailing address
307 N CALLE DEL CHANCERO, GREEN VALLEY, AZ 85614-3019
(520) 574-2364
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6420
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z 104140
GROUP LEGACY
AZ
Enumeration date
02/19/2008
Last updated
02/19/2008
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