Provider Demographics
NPI:1790423119
Name:VAUGHT, SAMANTHA ALLISON (DPT)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:ALLISON
Last Name:VAUGHT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:ALLISON
Other - Last Name:MEADOWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:BEAN STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37708-0608
Mailing Address - Country:US
Mailing Address - Phone:423-317-7772
Mailing Address - Fax:
Practice Address - Street 1:113 HEDRICK DR
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:TN
Practice Address - Zip Code:37821-2930
Practice Address - Country:US
Practice Address - Phone:423-438-1124
Practice Address - Fax:423-317-7773
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist