Organization Name: | MAGNOLIA REHAB SERVICES |
NPI Number: | 1427072370 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY GAULT (PRESIDENT) |
Mailing Address: | 3565 Austell Road Suite 11 Marietta |
State: | GA US |
Postal Code: | 300085770 |
Phone Number: | 7703198000 |
Fax Number: | |
NPI Enumeration Date: | 07/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |