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General NPI Number Information
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NPI Number | 1558327585
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Entity Type | Organization
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Legal Business Name | BAGLEY CHIROPRACTIC & WELLNESS CENTER P.A.
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 06/11/2010
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Provider Practice Location Address
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Address Line | 3821 JUNIPER TRCE STE. 207
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City | BEE CAVES
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State | TX
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Zip | 78738-5506
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Country | US
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Telephone | 512-263-0040
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Fax | 512-263-0026
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Provider Business Mailing Address
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Address Line | 3821 JUNIPER TRCE STE. 207
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City | BEE CAVES
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State | TX
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Zip | 78738-5506
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Country | US
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Telephone | 512-263-0040
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Fax | 512-263-0026
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. JARROD LYNN BAGLEY
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Credential | D.C.
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Telephone | 512-263-0040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10179
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License Number State | TX
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