Magnolia Functional Medicine, Llc

LBN: Magnolia Functional Medicine, Llc
Magnolia Functional Medicine, Llc is an health care organization with primary practice located at 1064 Gardner Rd Ste 208 , Charleston SC 29407-1712. The organization recently has 3 registered licenses in different health care specialties including Other Service Providers / Naturopath, Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is the primary health care specialty. Magnolia Functional Medicine, Llc can be contacted via phone (843) 501-2333, or through Green, Jessica via phone (843) 513-9577.

Contact Information

Primary practice address
1064 Gardner Rd Ste 208 Charleston SC 29407-1712
Phone: (843) 501-2333
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Green, Jessica
Phone: (843) 513-9577

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Naturopath 175F00000X
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X
Allopathic & Osteopathic Physicians / General Practice 208D00000X

Profile Details

NPI number 1952196826
LBN Legal business name Magnolia Functional Medicine, Llc
DBA Doing business as
Authorized official Green, Jessica
Entity Organization
Organization subpart 1 No
Enumeration date Apr 11th, 2025
Last updated May 15th, 2026 - about 5 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers