Individual
DANIEL P BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2620 TENDERFOOT HILL ST, SUITE 200, COLORADO SPRINGS, CO 80906-8353
(719) 527-6747
(719) 531-0880
Mailing address
2226 STAFFORD LANE, COLORADO SPRINGS, CO 80909
(678) 787-1886
(719) 531-0880
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT0016705
CO
Other
Enumeration date
10/31/2014
Last updated
10/31/2014
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