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Individual

MARILYN B MAGONI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
2515 DOUBLE CHURCHES RD, COLUMBUS, GA 31909
(706) 660-1146
(706) 321-0130
Mailing address
P.O. BOX 12094, COLUMBUS, GA 31917-2094
(706) 321-0130
(706) 321-0130

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT000187
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
330373
WELLCARE PROVIDER CMO
GA
01
52614399-001
BCBS PROVIDER
GA
Enumeration date
12/14/2006
Last updated
07/09/2007
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