Vaughan, Clark K

Vaughan, Clark K is an individual health care provider with primary practice located at 109 College Ave , Beckley WV 25801-6018. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Vaughan, Clark K can be contacted via phone (304) 545-2152.

Contact Information

Primary practice address
109 College Ave Beckley WV 25801-6018
Phone: (304) 545-2152
Fax: (304) 255-7120
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 01221 West Virginia

Profile Details

NPI number 1659365898
LBN Legal business name Vaughan, Clark K
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Nov 23rd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659365898 NPPES
West Virginia MEDICAID 157476000

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