Individual
KEITH ANTHONY AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3121 W BROAD ST, COLUMBUS, OH 43204-1306
(614) 869-2002
Mailing address
3114 ELLIS PL, COLUMBUS, OH 43204-1958
(602) 809-3185
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.005395
OH
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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