| Magnolia Physical Therapy | |
|
1189 N Euclid St Anaheim CA 92801-1938 | |
| (714) 808-0008 | |
| (714) 808-0168 |
| Full Name | Magnolia Physical Therapy |
|---|---|
| Speciality | Clinic/center |
| Location | 1189 N Euclid St, Anaheim, California |
| Authorized Official Name and Position | Carol M. Fracalosy (OWNER) |
| Authorized Official Contact | 7148080008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Physical Therapy 1189 N Euclid St Anaheim CA 92801-1938 Ph: (714) 808-0008 | Magnolia Physical Therapy 1189 N Euclid St Anaheim CA 92801-1938 Ph: (714) 808-0008 |
| NPI Number | 1710934666 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710934666 | NPI | - | NPPES |
| GPT001610 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | BUS2003-01454 (California) | Primary |
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