Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 1965 | MO |
NPI | 1114545407 |
---|---|
Provider Name | Jalecia S Vaughn |
First Address | Chillicothe, OH 45601-9718 |
Second Address | Chillicothe, OH 45601-9718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2020 |
Last Update Date | 13/07/2020 |