Individual
GARY LEE VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
622 INDIAN TRAIL RD, INDIAN TRAIL, NC 28079
(704) 821-6700
(704) 821-8534
Mailing address
622 INDIAN TRAIL RD, INDIAN TRAIL, NC 28079
(704) 821-6700
(704) 821-8534
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
941
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8802087
—
NC
Enumeration date
11/30/2007
Last updated
11/30/2007
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