MEDICARE: DAVID MCINTOSH DC

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	2021017233	MO

General Provider Information

NPI Number	:	1922672336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MCINTOSH DC

Provider Business Mailing Address
First Line	:	1862 CRAIGSHIRE RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-4006
Country	:	US
Telephone Number	:	314-628-9898
Fax Number	:

Provider Business Practice Location Address
First Line	:	1862 CRAIGSHIRE RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-4006
Country	:	US
Telephone Number	:	314-628-9898
Fax Number	:

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

Provider Enumeration Date	:	05/19/2021
Last Update Date	:	05/19/2021

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