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Individual

MARIA BAGWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
7580 CHARLOTTE HWY STE 500, INDIAN LAND, SC 29707-7809
(803) 548-5662
Mailing address
15610 WEEPING VALLEY DR, PINEVILLE, NC 28134-6454

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5380
SC

Other

Enumeration date
07/02/2014
Last updated
07/02/2014
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