Provider Demographics
NPI:1700769437
Name:MAGNOLIA CIRCLE WELLNESS
Entity type:Organization
Organization Name:MAGNOLIA CIRCLE WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMABELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:EQUIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-297-5236
Mailing Address - Street 1:1302 FREEDOM LN
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:MN
Mailing Address - Zip Code:55328-2300
Mailing Address - Country:US
Mailing Address - Phone:952-297-5236
Mailing Address - Fax:
Practice Address - Street 1:1302 FREEDOM LN
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:MN
Practice Address - Zip Code:55328-2300
Practice Address - Country:US
Practice Address - Phone:952-297-5236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health