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General NPI Number Information
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NPI Number | 1356200158
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Entity Type | Individual
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Provider Name | VASHAWN ANTWON MCNAIR
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Gender | Male
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Dates
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Enumeration Date | 01/17/2026
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Last Update Date | 01/17/2026
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Provider Practice Location Address
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Address Line | 409 PLEASANT HOME RD
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City | AUGUSTA
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State | GA
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Zip | 30907-3523
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Country | US
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Telephone | 706-863-6030
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Fax |
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Provider Business Mailing Address
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Address Line | 6094 VERMILION LOOP
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City | GRANITEVILLE
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State | SC
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Zip | 29829-3258
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Country | US
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Telephone | 706-993-5355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA002174
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License Number State | GA
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