Individual
GINA VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 N CLARK ST, CHICAGO, IL 60614-3487
(773) 340-1897
Mailing address
61 E 21ST ST UNIT 313, CHICAGO, IL 60616-1714
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227020808
IL
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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