Individual
MICHAEL BRENT BAGWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
7321 BALMER ST BLDG 570, HILL AFB, UT 84056-5012
(801) 777-5400
Mailing address
7321 BALMER ST BLDG 570, HILL AFB, UT 84056-5012
(770) 530-0082
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
64152
OR
225100000X
Physical Therapist
Primary
PT-7198
ID
Other
Enumeration date
06/16/2021
Last updated
08/25/2025
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