# MAGNOLIA SPRINGS SKIN & WELLNESS CENTER PC LLC

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

## Provider details

- **NPI number:** 1689141822
- **Authorized official:** SHARI WOODY (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (251) 263-4991

## Contact information

- **Practice address:** 12440 MAGNOLIA SPRINGS HWY STE 200, MAGNOLIA SPRINGS, AL 36555-6422
- **Practice address phone:** (251) 263-4991
- **Practice address fax:** (888) 339-7886
- **Mailing address:** 12440 MAGNOLIA SPRINGS HWY STE 200, MAGNOLIA SPRINGS, AL 36555-6422
- **Mailing address phone:** (251) 263-4991
- **Mailing address fax:** (888) 339-7886

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/25/2018
- **Last updated:** 11/06/2018