Individual
MR. JOHN BAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
4201 S 14TH ST, LINCOLN, NE 68502-5336
(402) 479-3292
Mailing address
4201 S 14TH ST, LINCOLN, NE 68502-5336
(402) 479-3292
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
794
NE
Other
Enumeration date
10/11/2007
Last updated
10/11/2007
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