Provider Demographics
NPI:1306991443
Name:MAGEE, PAUL ROBERT (DIPL AC, LAC)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ROBERT
Last Name:MAGEE
Suffix:
Gender:M
Credentials:DIPL AC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 KING ST W
Mailing Address - Street 2:APT. 1
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55107-2542
Mailing Address - Country:US
Mailing Address - Phone:651-293-9019
Mailing Address - Fax:
Practice Address - Street 1:6545 FRANCE AVE S
Practice Address - Street 2:SUITE C-21
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2131
Practice Address - Country:US
Practice Address - Phone:952-922-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNPERMIT # 1231171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist