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Individual

DR. HARRISON NEAL VAUGHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1187 N MECKLENBURG AVE, LA CROSSE, VA 23950-1768
(434) 447-3322
Mailing address
PO BOX 217, SOUTH HILL, VA 23970-0217
(434) 447-3322
(434) 447-3282

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305205478
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00702769
RAILROAD MEDICARE PTAN
VA
Enumeration date
06/23/2008
Last updated
06/16/2009
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