Individual
KEVIN VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
425 SUMMIT TERRACE CT, BLDG 1 STE -A1, COLUMBIA, SC 29229
(803) 760-6169
Mailing address
400 SHALLOW BROOK DR, COLUMBIA, SC 29223-8114
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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