Individual ProviderJayme Ellen VaughanPhysical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1040 Pilgrim Way, Green Bay, WI 54304-5028(920) 499-1481(920) 851-3432PECOS EnrollmentBased on the most recent information from CMS, provider Jayme Ellen Vaughan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1790110104Provider TypeIndividualFull NameVaughan, Jayme EllenTitleMrs.CredentialPTAGenderFemaleSole ProprietorYesEnumeration Date9/5/2013Last Updated9/9/2022Contact InformationPractice LocationPractice Address1040 Pilgrim Way, Green Bay, WI 54304-5028Phone(920) 499-1481FaxUnlisted FaxMailing LocationMailing Address1307 Valley View Rd, Green Bay, WI 54304-4036Phone(920) 851-3432FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225200000XPrimaryDescriptionPhysical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense2041-19Wisconsin