Individual
AMY BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2571 FOREST DR, COLUMBIA, SC 29204-2029
(803) 254-2376
Mailing address
2571 FOREST DR, COLUMBIA, SC 29204-2029
(803) 254-2376
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13305
SC
Other
Enumeration date
08/30/2012
Last updated
08/30/2012
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