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1790110104
JAYME ELLEN VAUGHAN
GREEN BAY, WI
NPI
1790110104
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WI 2041-19)
Enumeration Date
2013-09-05
Last Update Date
2022-09-09
Business Address
Mrs. JAYME ELLEN VAUGHAN PTA
1040 PILGRIM WAY
GREEN BAY, WI 54304-5028
Phone number: 920-499-1481
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Mailing Address
Mrs. JAYME ELLEN VAUGHAN PTA
1307 VALLEY VIEW RD
GREEN BAY, WI 54304-4036
Phone number: 920-851-3432
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