Provider Demographics
NPI:1609432558
Name:MAGNOLIA FAMILY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:MAGNOLIA FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-869-5565
Mailing Address - Street 1:1106 FURYS LN STE A
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30907-8219
Mailing Address - Country:US
Mailing Address - Phone:706-869-5565
Mailing Address - Fax:706-869-5572
Practice Address - Street 1:1106 FURYS LN STE A
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-8219
Practice Address - Country:US
Practice Address - Phone:706-869-5565
Practice Address - Fax:706-869-5572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty