Provider Demographics
NPI:1760894398
Name:VAUGHN, JOSHUA A (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:A
Last Name:VAUGHN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 CRESTVIEW PARK DR.
Mailing Address - Street 2:SUITE 209
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055
Mailing Address - Country:US
Mailing Address - Phone:615-446-5121
Mailing Address - Fax:615-446-1357
Practice Address - Street 1:766 HIGHWAY 46 SOUTH
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055
Practice Address - Country:US
Practice Address - Phone:615-560-5112
Practice Address - Fax:615-560-5158
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9988225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist