Provider Demographics
NPI:1013288869
Name:MAGRAM, JULIE ELYSE (LAC)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ELYSE
Last Name:MAGRAM
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9831 GREENBELT RD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:SEABROOK
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2202
Mailing Address - Country:US
Mailing Address - Phone:443-610-8293
Mailing Address - Fax:
Practice Address - Street 1:9831 GREENBELT RD
Practice Address - Street 2:SUITE 311
Practice Address - City:SEABROOK
Practice Address - State:MD
Practice Address - Zip Code:20706-2202
Practice Address - Country:US
Practice Address - Phone:443-610-8293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01295171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist