# MAGNOLIA COMFORT MEDICAL SOUTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306630801
- **Authorized official:** KEVIN LE (CLINIC DIRECTOR / OWNER)
- **Authorized official phone:** (678) 268-8891

## Contact information

- **Practice address:** 7193 JONESBORO RD STE 101-102, MORROW, GA 30260-2961
- **Practice address phone:** (470) 726-1699
- **Mailing address:** 7193 JONESBORO RD STE 101-102, MORROW, GA 30260-2961
- **Mailing address phone:** (470) 726-1699

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/08/2025
- **Last updated:** 07/11/2025