Individual
MR. PAUL VAUGHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SCAT, ATC, OPE-C
Contact information
Practice address
1 FALCON DRIVE, COLUMBIA, SC 29204
(803) 738-7300
Mailing address
630 CANALSIDE ST UNIT 1008, COLUMBIA, SC 29201-6029
(318) 376-2528
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATH.J00202
LA
2255A2300X
Athletic Trainer
SC532593
SC
Other
Enumeration date
01/20/2016
Last updated
01/21/2022
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