Provider Demographics
NPI:1053322644
Name:MCINTIRE, CHAD EUGENE (PT)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:EUGENE
Last Name:MCINTIRE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HAVERHILL RD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2123
Mailing Address - Country:US
Mailing Address - Phone:978-388-4500
Mailing Address - Fax:
Practice Address - Street 1:110 HAVERHILL RD
Practice Address - Street 2:SUITE 401
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-2123
Practice Address - Country:US
Practice Address - Phone:978-388-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18656225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist