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Individual

MR. ADAM RICHARD VAUGHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
1306 GEMINI CIR STE 3, OTTAWA, IL 61350-1695
(815) 431-9980
(815) 431-9981
Mailing address
1051 W US ROUTE 6 STE 400, MORRIS, IL 60450-3370
(815) 942-8301
(815) 942-8449

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
IL

Other

Enumeration date
03/07/2007
Last updated
07/08/2007
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