Organization
MAGNOLIA COMFORT MEDICAL SOUTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN LE (CLINIC DIRECTOR / OWNER)
(678) 268-8891
Entity
Organization
Contact information
Practice address
7193 JONESBORO RD STE 101-102, MORROW, GA 30260-2961
(470) 726-1699
Mailing address
7193 JONESBORO RD STE 101-102, MORROW, GA 30260-2961
(470) 726-1699
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
04/08/2025
Last updated
07/11/2025
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