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General NPI Number Information
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NPI Number | 1215183504
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Entity Type | Organization
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Legal Business Name | VAUGHN CHIROPRACTIC
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 5330 S 3RD ST STE 222
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City | LOUISVILLE
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State | KY
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Zip | 40214-2687
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Country | US
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Telephone | 502-361-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 3502 LANCASTER DR
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City | NEW ALBANY
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State | IN
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Zip | 47150-2268
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Country | US
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Telephone | 502-298-4053
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID JAMES VAUGHN III
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Credential | D.C.
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Telephone | 502-361-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4514
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License Number State | KY
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