Individual
CARLY JOY BAGNALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
8030 SOQUEL AVE STE 200, SANTA CRUZ, CA 95062-2096
(831) 464-8200
Mailing address
145 ALTA AVE, SANTA CRUZ, CA 95060-6437
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT293266
CA
Other
Enumeration date
08/16/2017
Last updated
08/16/2017
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