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Individual

CAROL BAGENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1 MEDICAL PARK, WHEELING HOSPITAL INC, WHEELING, WV 26003
(304) 243-3124
(304) 243-6343
Mailing address
810 4TH ST, BRILLIANT, OH 43913-1110
(749) 598-4183

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1064
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OTA01820
OHIO LICENSE
OH
Enumeration date
01/26/2007
Last updated
07/08/2007
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