Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CR737 | ME |
NPI | 1225185572 |
---|---|
Provider Name | Dr. Thomas J. Augat |
First Address | Brunswick, ME 04011-2247 |
Second Address | Brunswick, ME 04011-2247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 10/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T31406 | (02) | ME |