Provider Demographics
NPI:1336630755
Name:VAUGHN, KAREN JANERT (PT,MTC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:JANERT
Last Name:VAUGHN
Suffix:
Gender:F
Credentials:PT,MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4863 PROMENADE PKWY STE 109
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-7309
Mailing Address - Country:US
Mailing Address - Phone:205-481-9012
Mailing Address - Fax:205-481-9014
Practice Address - Street 1:4863 PROMENADE PKWY STE 109
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-7309
Practice Address - Country:US
Practice Address - Phone:205-481-9012
Practice Address - Fax:205-481-9014
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7682251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic