Individual
MR. PAUL MICHAEL VAUGHAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
200 VETERANS AVE, BECKLEY, WV 25801-6444
(304) 255-2121
Mailing address
610 TEEL RD, BECKLEY, WV 25801-2340
(304) 255-2121
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
000159
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000159
STATE PT LICENSE
WV
Enumeration date
05/05/2006
Last updated
07/08/2007
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