Organization
MAGNOLIA NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE OCHENDUSZKO (OCCUPATIONAL THERAPIST)
(419) 410-6371
Entity
Organization
Contact information
Practice address
804 CRANDALL HALL, FLORENCE, SC 29501-1489
(843) 610-3795
(843) 669-5114
Mailing address
804 CRANDALL HALL, FLORENCE, SC 29501-1489
(843) 610-3795
(843) 669-5114
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2960
SC
Other
Enumeration date
02/22/2009
Last updated
02/22/2009
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