Provider Demographics
NPI:1104068618
Name:BAGLEY, ELIZABETH M (DC)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:M
Last Name:BAGLEY
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2952 DOUGHERTY FERRY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3366
Mailing Address - Country:US
Mailing Address - Phone:314-596-4070
Mailing Address - Fax:
Practice Address - Street 1:2952 DOUGHERTY FERRY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3366
Practice Address - Country:US
Practice Address - Phone:314-596-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008000933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor