Individual
JULIE MACGREGOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, LE
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
EE-285937
ID
363AM0700X
Medical Physician Assistant
PA-1613
ID
363AS0400X
Surgical Physician Assistant
PA165087
OR
Other
Enumeration date
09/24/2013
Last updated
09/30/2024
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