Individual
HENRY VAUGHN IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
469 HUNTINGTON TRAILS DR, FESTUS, MO 63028-5469
(636) 937-6911
Mailing address
469 HUNTINGTON TRAILS DR, FESTUS, MO 63028-5469
(636) 937-6911
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
045030
MO
Other
Enumeration date
09/28/2011
Last updated
09/28/2011
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