Provider / Organization | NPI | Date Certified |
---|---|---|
JENNIFER REGINA VAUGHN | 1396290482 | 2022-12-04 |
Jennifer Regina Vaughn is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1396290482. Registration indicates Jennifer Regina Vaughn is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Massage Therapist (Massage Therapist, ) (Massage Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
Entity Type | Individual |
Provider Name | Jennifer Regina Vaughn LMT |
Practice Office Address | 580 BLACKSTONE ALLEY JACKSONVILLE, OR US |
Practice Office Telephone | 5419302445 |
Practice Office Fax | 5413198748 |
Mailing Address | 2695 ORCHARD HOME DR MEDFORD, OR 975014234 US |
Business Telephone | 5419302445 |
Business Fax | 5413198748 |
Code | Practice | License No State |
---|---|---|
225700000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Massage Therapist Massage Therapist Massage Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | 22543
OR |