Organization
MAGNOLIA FAMILY MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON BRYCE SWALM D.O. (SOLE MEMBER)
(304) 267-6249
Entity
Organization
Contact information
Practice address
3 CERITOS TRAIL, MARTINSBURG, WV 25403-0300
(304) 267-6249
(304) 267-6248
Mailing address
3 CERITOS TRAIL, MARTINSBURG, WV 25403-0300
(304) 267-6249
(304) 267-6248
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2952
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962745950
—
WV
Enumeration date
09/01/2016
Last updated
11/14/2016
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