Individual
MRS. JENNIFER ANDERSON BAGLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1018 DRUID PARK AVE, AUGUSTA, GA 30904-5848
(706) 737-7371
(706) 737-7372
Mailing address
579 FAIRFIELD WAY, EVANS, GA 30809-3624
(706) 814-1099
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4837
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4837
GEORGIA PHYSICAL THERAPY LICENSE NUMBER
GA
Enumeration date
02/03/2016
Last updated
02/03/2016
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