ALISA VAUGHN

BELLEVILLE, IL
NPI1093297400
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy247200000X Technician, Other
(Licence: IL  012.008627)
Enumeration Date2018-08-31
Last Update Date2018-08-31
Business Address
ALISA VAUGHN
9601 W MAIN ST
BELLEVILLE, IL 62223-1415
Phone number: 618-917-2251
Mailing Address
ALISA VAUGHN
9601 W MAIN ST
BELLEVILLE, IL 62223-1415
Phone number: 618-917-2251