Healthcare Provider Details

I. General information

NPI: 1306911490
Provider Name (Legal Business Name): ALISON MCINTYRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3051 COMMERCE DR STE 5
FORT GRATIOT MI
48059-3866
US

IV. Provider business mailing address

3648 GUIZAR AVE
FORT GRATIOT MI
48059-3743
US

V. Phone/Fax

Practice location:
  • Phone: 810-385-4463
  • Fax:
Mailing address:
  • Phone: 810-385-4402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: