Individual
SHANNON VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
2600 W HUDSON RD, ROGERS, AR 72756-2028
(479) 621-6126
Mailing address
2600 W HUDSON RD, ROGERS, AR 72756-2028
(479) 936-1061
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
225200000X
AR
Other
Enumeration date
05/14/2021
Last updated
05/14/2021
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