Provider Demographics
NPI:1336902675
Name:VAUGHN, BROOKE ELIZABETH (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ELIZABETH
Last Name:VAUGHN
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Gender:F
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:2800 CLAY EDWARDS DR
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3220
Mailing Address - Country:US
Mailing Address - Phone:816-691-1795
Mailing Address - Fax:816-346-7105
Practice Address - Street 1:2800 CLAY EDWARDS DR
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3220
Practice Address - Country:US
Practice Address - Phone:816-691-1795
Practice Address - Fax:816-346-7105
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2001023258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist