Individual
LORI CRENSHAW VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
610 SPARTA RD, SANDERSVILLE, GA 31082-1860
(478) 240-2176
(478) 240-2380
Mailing address
610 SPARTA RD, SANDERSVILLE, GA 31082-1860
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT009676
GA
Other
Enumeration date
08/09/2009
Last updated
08/09/2009
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