Provider Demographics
NPI:1538227996
Name:AUGUST, JR., HAROLD MAXWELL (PT)
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:MAXWELL
Last Name:AUGUST, JR.
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 LIBERTY AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-3626
Mailing Address - Country:US
Mailing Address - Phone:931-359-7557
Mailing Address - Fax:
Practice Address - Street 1:451 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-3626
Practice Address - Country:US
Practice Address - Phone:931-359-7557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT00000000465225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist