Maria Bagwell, P.T.

Individual provider Active NPI Physical Therapist · Indian Land, SC

NPI 1043626864 · NPPES record last updated Jul 2, 2014

Key facts

NPI
1043626864
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5380 (SC)
Practice address
7580 Charlotte Hwy Ste 500
Indian Land, SC 29707-7809
Phone
(803) 548-5662
NPI assigned
Jul 2, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5380SCMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5380 SC Yes

Addresses

Primary practice location

7580 Charlotte Hwy Ste 500
Indian Land, SC 29707-7809

Mailing address

15610 Weeping Valley Dr
Pineville, NC 28134-6454

Other providers in Indian Land, SC

All providers in Indian Land, SC · Physical Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.