Individual
DR. CHARLES F VAUGHN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
12258 SAINT CHARLES ROCK RD, BRIDGETON, MO 63044-2501
(314) 739-7979
Mailing address
920 RUTH DR, SAINT CHARLES, MO 63301-1154
(314) 754-8466
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
005016
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122599431327528
HEALTHLINK CUSTOMER ID
MO
01
—
13770
BLUE CROSS
MO
Enumeration date
05/10/2006
Last updated
11/02/2011
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