Individual
RUTHELL VAUGHNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
155 GRAY FOX PT, FAYETTEVILLE, GA 30214-3695
(678) 817-1774
(678) 221-0302
Mailing address
155 GRAY FOX PT, FAYETTEVILLE, GA 30214-3695
(678) 817-1774
(678) 221-0302
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA000627
GA
Other
Enumeration date
11/15/2016
Last updated
11/15/2016
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