Individual
MARK P MAGENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
115 S PARK AVE, EAGLE GROVE, IA 50533-2219
(515) 448-5185
Mailing address
24 N 9TH ST, SUITE A, FORT DODGE, IA 50501-3909
(515) 574-6890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000816
IA
Other
Enumeration date
02/01/2006
Last updated
09/25/2007
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