Organization
MAGNOLIA ADDICTION TREATMENT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD W TROSCLAIR MD (CLINICAL MANAGER)
(504) 905-2965
Entity
Organization
Contact information
Practice address
500 E WOODROW WILSON AVE STE D, JACKSON, MS 39216-4538
(601) 896-0349
Mailing address
500 E WOODROW WILSON AVE STE D, JACKSON, MS 39216-4538
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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