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1184188740
KELLY JO BAGNELL
TORRANCE, CA
NPI
1184188740
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2019-01-29
Last Update Date
2019-05-21
Business Address
KELLY JO BAGNELL ATC
23420 SUSANA AVE
TORRANCE, CA 90505-5430
Phone number: 310-367-0663
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Mailing Address
KELLY JO BAGNELL ATC
8 SAINT LUKES RD
ALLSTON, MA 02134-3100
Phone number:
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