Individual
JAIME VAUGHN SHULLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
412 W AVENUE J, LANCASTER, CA 93534-3685
(661) 945-0884
Mailing address
618 N KNIGHT DR, EDWARDS, CA 93523-2735
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
43070
CA
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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