Individual
MRS. LORI A BAGNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,LD
Contact information
Practice address
201 WALLS DR, CLEBURNE, TX 76033-4007
(817) 556-4267
Mailing address
12444 SEVEN EAGLES LN, BURLESON, TX 76028-7554
(817) 551-5501
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT05893
TX
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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