Individual
MR. NICHOLAS BAGBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
25023 BOTHWELL PARK RD, SEDALIA, MO 65301-0084
(660) 827-3993
Mailing address
104 COOPER ST, FAYETTE, MO 65248-1008
(660) 888-2464
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2010031392
MO
Other
Enumeration date
08/30/2011
Last updated
08/30/2011
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