Provider Demographics
NPI:1194731943
Name:MAGEE, GINA ELIZABETH (PT)
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:ELIZABETH
Last Name:MAGEE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:ELIZABETH
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2105 NW 26TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-2507
Mailing Address - Country:US
Mailing Address - Phone:405-315-2571
Mailing Address - Fax:
Practice Address - Street 1:701 NE 10TH ST
Practice Address - Street 2:SUITE 33
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5403
Practice Address - Country:US
Practice Address - Phone:405-232-8003
Practice Address - Fax:405-232-8008
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3570225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist