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General NPI Number Information
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NPI Number | 1760012041
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Entity Type | Individual
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Provider Name | WENDY L MCINTYRE
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Gender | Female
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Dates
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Enumeration Date | 01/25/2020
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 11110 KINSMAN RD
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City | NEWBURY
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State | OH
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Zip | 44065-8603
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Country | US
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Telephone | 440-564-7007
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Fax |
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Provider Business Mailing Address
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Address Line | 8700 GALLOWAY TRL
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City | NOVELTY
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State | OH
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Zip | 44072-9653
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Country | US
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Telephone | 440-781-1996
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 33.023240
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License Number State | OH
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