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NPI Code Detail

MEDICARE: MELISSA MICHELLE MCINTYRE DPT

MEDICARE:   MELISSA MICHELLE MCINTYRE  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
1225100000XPhysical Therapist9829785-2401UT

General Provider Information

NPI Number : 1659816072
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA MICHELLE MCINTYRE DPT
Provider Business Mailing Address
First Line : 15 N 2030 E RM 2270A
Second Line :
City : SLC
State : UT
Zip : 84112-5339
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15 N 2030 E RM 2270A
Second Line :
City : SLC
State : UT
Zip : 84112-5339
Country : US
Telephone Number : 801-585-0893
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2016
Last Update Date : 12/20/2016

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Directions to “ MELISSA MICHELLE MCINTYRE DPT” Practice Location

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