Provider Demographics
NPI:1093069759
Name:MAGNUSON, CHERYL LEE (DVM)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:LEE
Last Name:MAGNUSON
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2152 HIDDEN WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-3393
Mailing Address - Country:US
Mailing Address - Phone:813-956-1499
Mailing Address - Fax:
Practice Address - Street 1:2152 HIDDEN WOODS BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45431-3393
Practice Address - Country:US
Practice Address - Phone:813-956-1499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5304174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian