Provider Demographics
NPI:1851767248
Name:MAGEE, ANGELA FAYE (LMT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:FAYE
Last Name:MAGEE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8353 S CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-8337
Mailing Address - Country:US
Mailing Address - Phone:228-314-4996
Mailing Address - Fax:
Practice Address - Street 1:8353 S CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-8337
Practice Address - Country:US
Practice Address - Phone:228-314-4996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2345171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist