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General NPI Number Information
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NPI Number | 1790142180
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Entity Type | Organization
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Legal Business Name | MCINTYRE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 11 POINTVIEW DR
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City | BONNE TERRE
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State | MO
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Zip | 63628-1355
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Country | US
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Telephone | 573-534-7070
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Fax | 573-534-7071
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Provider Business Mailing Address
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Address Line | PO BOX 176
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City | BONNE TERRE
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State | MO
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Zip | 63628-0176
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Country | US
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Telephone | 573-534-7070
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Fax | 573-534-7071
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | LAUREN DANIELLE MCINTYRE
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Credential | DC
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Telephone | 573-631-8469
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2016000303
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License Number State | MO
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