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1164904264
EVAN JAMES BAGWELL
ATHENS, GA
NPI
1164904264
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2018-09-05
Last Update Date
2018-09-05
Business Address
EVAN JAMES BAGWELL
330 RIVER RD
ATHENS, GA 30602-1538
Phone number: 864-934-7523
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Mailing Address
EVAN JAMES BAGWELL
153 MASSEY RD
PIEDMONT, SC 29673-9056
Phone number:
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