Organization
MAGNOLIA MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRADEEP RAJ RAI (MEDICAL DIRECTOR)
(303) 209-5115
Entity
Organization
Contact information
Practice address
2172 S CLERMONT ST, DENVER, CO 80222-5007
(303) 209-5115
Mailing address
2172 S CLERMONT ST, DENVER, CO 80222-5007
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
02/18/2016
Last updated
11/10/2016
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