Individual
DAWNIAL VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26317 W WASHINGTON ST, PETERSBURG, VA 23803
(804) 524-7346
Mailing address
24010 BANCROFT DR, PETERSBURG, VA 23803-8437
(804) 733-4306
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
0230006557
VA
Other
Enumeration date
02/16/2007
Last updated
07/08/2007
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