Individual
DOUGLAS K BAGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1055 N 500 W, SUITE 207, PROVO, UT 84604-3305
(801) 375-4263
(801) 429-8085
Mailing address
1055 N 500 W, CREDENTIALING DEPARTMENT, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
2251H1200X
Hand Physical Therapist
Primary
121795-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0224632005
CIGNA
UT
01
—
6400377
UNITED HEALTHCARE
UT
01
—
77717
PEHP
UT
Enumeration date
09/26/2005
Last updated
11/27/2023
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