Individual
CALLY VAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
101 S MAIN ST, DEFOREST, WI 53532-1109
(608) 846-5625
Mailing address
101 S MAIN ST, DEFOREST, WI 53532-1109
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3696-35
WI
Other
Enumeration date
06/21/2021
Last updated
09/06/2023
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