Individual
DOMINIQUE RENEE BAGBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
7540 N 19TH AVE STE 101, PHOENIX, AZ 85021-7967
(602) 249-9129
(602) 249-4115
Mailing address
7540 N 19TH AVE STE 101, PHOENIX, AZ 85021-7967
(602) 249-9129
(602) 249-4115
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13198
AZ
2251X0800X
Orthopedic Physical Therapist
13198
AZ
Other
Enumeration date
08/08/2017
Last updated
07/21/2022
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