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Individual

KEITH A VAUGHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
401 SCENIC DR, ROGERSVILLE, TN 37857-2452
(423) 921-7224
(423) 921-7227
Mailing address
161 CORALWOOD DR, KINGSPORT, TN 37663-2709
(423) 239-4366
(423) 224-5776

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0105006341
VA
225100000X
Physical Therapist
Primary
PT0000003655
TN

Other

Enumeration date
03/26/2007
Last updated
03/01/2011
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