MEDICARE: W. PATRICK MAGEE, PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1134881030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	W. PATRICK MAGEE, PT, DPT

Provider Business Mailing Address
First Line	:	3397 NW FEDERAL HWY
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-4456
Country	:	US
Telephone Number	:	772-692-6994
Fax Number	:	772-694-6995

Provider Business Practice Location Address
First Line	:	3397 NW FEDERAL HWY
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-4456
Country	:	US
Telephone Number	:	772-692-6994
Fax Number	:	772-692-6995

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. WILLIAM PATRICK MAGEE JR.
Credential	:	PT, DPT
Telephone Number	:	772-692-6994

Provider Enumeration Date	:	10/07/2021
Last Update Date	:	10/07/2021

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