MEDICARE: DR. BRIAN K. MCINTYRE D.C.

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
1	111N00000X	Chiropractor	CE005664	MO

General Provider Information

NPI Number	:	1275545840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN K. MCINTYRE D.C.

Provider Business Mailing Address
First Line	:	1415 S BIG BEND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63117-2203
Country	:	US
Telephone Number	:	314-644-7776
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 S BIG BEND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63117-2203
Country	:	US
Telephone Number	:	314-644-7776
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	01/29/2009

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