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Organization
MAGNOLIA NEURO REHAB, LLC
Active
Organization
MAGNOLIA NEURO REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY PACILLO OTR/L (OWNER)
(256) 513-9444
Entity
Organization
Contact information
Practice address
805 REGAL DR SW STE 2, HUNTSVILLE, AL 35801-5657
(256) 513-9444
Mailing address
805 REGAL DR SW STE 2, HUNTSVILLE, AL 35801-5657
(256) 513-9444
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
NULL
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
NULL
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
10/12/2022
Last updated
04/06/2026
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