Individual
MRS. JAYME ELLEN VAUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1040 PILGRIM WAY, GREEN BAY, WI 54304-5028
(920) 499-1481
Mailing address
1307 VALLEY VIEW RD, GREEN BAY, WI 54304-4036
(920) 851-3432
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2041-19
WI
Other
Enumeration date
09/05/2013
Last updated
09/09/2022
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