Individual
MR. CHARLES BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
19768 YORBA LINDA BLVD, YORBA LINDA, CA 92886-2801
(714) 693-0460
Mailing address
19768 YORBA LINDA BLVD, YORBA LINDA, CA 92886-2801
(714) 693-0460
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT24597
CA
Other
Enumeration date
07/14/2006
Last updated
01/29/2013
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