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Organization
MAGNOLIA MED SPA AND IV THERAPY INC.
Active
Organization
MAGNOLIA MED SPA AND IV THERAPY INC.
Active
Other names
MAGNOLIA MED SPA AND IV THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANY LEE BALLARD BSN (OWNER)
(580) 615-0000
Entity
Organization
Contact information
Practice address
3008 W UNIVERSITY BLVD STE 130, DURANT, OK 74701-2927
(580) 615-0000
(580) 615-0001
Mailing address
3008 W UNIVERSITY BLVD STE 130, DURANT, OK 74701-2927
(580) 615-0000
(580) 615-0001
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/16/2024
Last updated
07/16/2024
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