Individual
ANDA MICHELLE VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5358 E BASELINE ROAD, MESA, AZ 85206
(480) 699-9224
Mailing address
7214 E KAEL ST, MESA, AZ 85207-1917
(480) 540-8737
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8683
AZ
Other
Enumeration date
05/12/2011
Last updated
05/12/2011
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