Individual
MISS MARY GRACE MAGALONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4300 W. MAIN STREET, SUITE 102, DOTHAN, AL 36305-1051
(334) 793-9564
(334) 671-8907
Mailing address
4300 W. MAIN STREET, SUITE 102, DOTHAN, AL 36305-1051
(334) 793-9564
(334) 671-8907
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
32733
AL
207RP1001X
Pulmonary Disease Physician
A72152
CA
Other
Enumeration date
09/07/2006
Last updated
09/13/2013
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