Magnolia Pediatric Therapy, LLC

NPI #1689176323 in Madison, Mississippi

Provider Information

NPI Number: 1689176323
Entity Type: Organization
Organization Name: Magnolia Pediatric Therapy, LLC
Primary Specialty: Occupational Therapist
Enumeration Date: Mar 7, 2018
Last Updated: Mar 7, 2018

Practice Location

Address: 239 CLARK FARMS RD
City: Madison
State: Mississippi
ZIP Code: 39110-8115
Phone: (601) 519-8930

Authorized Official

Name: JAMIE AUSTIN, OTR/L
Title: OCCUPATIONAL THERAPIST
Phone: (601) 519-8930

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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