Provider Demographics
NPI:1679146658
Name:MAGNOLIA REHABILITATION CONSULTANTS INC
Entity Type:Organization
Organization Name:MAGNOLIA REHABILITATION CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWANEBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-803-5799
Mailing Address - Street 1:2905 STANFORD RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2518
Mailing Address - Country:US
Mailing Address - Phone:662-803-5799
Mailing Address - Fax:
Practice Address - Street 1:700 POTOMAC ST FL 2
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6846
Practice Address - Country:US
Practice Address - Phone:662-803-5799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty