Healthcare Provider Details

I. General information

NPI: 1700622057
Provider Name (Legal Business Name): PURE MAGEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2024
Last Update Date: 07/06/2024
Certification Date: 07/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 MOROSS RD
GROSSE POINTE FARMS MI
48236-2946
US

IV. Provider business mailing address

285 MOROSS RD
GROSSE POINTE FARMS MI
48236-2946
US

V. Phone/Fax

Practice location:
  • Phone: 248-202-3220
  • Fax:
Mailing address:
  • Phone: 248-202-3220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN MAGEE
Title or Position: OWNER
Credential: PT, DPT, OCS
Phone: 248-202-3220