Individual
TAYLOR MACKENZIE VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2 HARBOR BEND CT STE 102, LAKE ST LOUIS, MO 63367-1480
(636) 695-2070
Mailing address
2576 ABBYDALE DR, SAINT CHARLES, MO 63303-3013
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2021033584
MO
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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