Individual
LINDA FONTAINE VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 RIVERSTONE VIS STE 102, BLUE RIDGE, GA 30513-6630
(706) 258-4140
Mailing address
649 SUGAR CREEK RD, BLUE RIDGE, GA 30513-4070
(678) 410-3036
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
016565
GA
Other
Enumeration date
09/20/2019
Last updated
09/20/2019
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