Provider Demographics
NPI:1023648508
Name:AUGUSTUS, LUKE EDWARD (LMT)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:EDWARD
Last Name:AUGUSTUS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 E SANDUSKY AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTAINE
Mailing Address - State:OH
Mailing Address - Zip Code:43311-2856
Mailing Address - Country:US
Mailing Address - Phone:937-404-1214
Mailing Address - Fax:
Practice Address - Street 1:920 E SANDUSKY AVE
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-2856
Practice Address - Country:US
Practice Address - Phone:937-404-1214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No172M00000XOther Service ProvidersMechanotherapist