Individual
VAUGHN CHARLES ADLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
21 BIRCH LN, VALLEY STREAM, NY 11581-1773
(917) 476-0595
Mailing address
9131 175TH ST, JAMAICA, NY 11432-5517
(718) 657-6363
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
018053
NY
Other
Enumeration date
12/27/2017
Last updated
12/27/2017
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