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NPI Code Detail

MEDICARE: MAGNOLIA PHYSICAL THERAPY, INC

MEDICARE: MAGNOLIA PHYSICAL THERAPY, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/CenterA165984CA

General Provider Information

NPI Number : 1982642336
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAGNOLIA PHYSICAL THERAPY, INC
Provider Business Mailing Address
First Line : 19032 MAGNOLIA ST
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92646-2232
Country : US
Telephone Number : 714-968-3003
Fax Number : 714-968-4220
Provider Business Practice Location Address
First Line : 19032 MAGNOLIA ST
Second Line :
City : HUNTINGTON BEACH
State : CA
Zip : 92646-2232
Country : US
Telephone Number : 714-968-3003
Fax Number : 714-968-4220
Authorized Official
Title or Position : OWNER
Name : MRS. CAROL M. FRACALOSY
Credential : P.T.
Telephone Number : 714-968-3003
Provider Enumeration Date : 06/04/2006
Last Update Date : 06/26/2008

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Directions to “MAGNOLIA PHYSICAL THERAPY, INC ” Practice Location

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