Provider Demographics
NPI:1336673870
Name:MAGEE, MEGAN (DTR)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:MAGEE
Suffix:
Gender:F
Credentials:DTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13255 CLERMONT CIR
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-1539
Mailing Address - Country:US
Mailing Address - Phone:303-921-7640
Mailing Address - Fax:
Practice Address - Street 1:13255 CLERMONT CIR
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-1539
Practice Address - Country:US
Practice Address - Phone:303-921-7640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO962148136A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes136A00000XDietary & Nutritional Service ProvidersDietetic Technician, Registered