Organization
PHYLLIS MAGELKY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER MAGELKY (OWNER)
(701) 364-9070
Entity
Organization
Contact information
Practice address
3509 INTERSTATE BLVD S STE B, FARGO, ND 58103-2200
(701) 364-9070
(701) 364-9071
Mailing address
3509 INTERSTATE BLVD S STE B, FARGO, ND 58103-2200
(701) 364-9070
(701) 364-9071
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55482
—
ND
Enumeration date
11/02/2009
Last updated
03/14/2017
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