Individual
REBECCA BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LDN
Contact information
Practice address
7730 OLD CANTON RD BLDG A, MADISON, MS 39110-9299
(601) 499-0935
(601) 499-0936
Mailing address
7731 OLD CANTON RD STE B, MADISON, MS 39110-6115
(601) 499-0935
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
01/05/2023
Last updated
12/07/2023
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