Provider Demographics
NPI:1245302306
Name:MCINTYRE, SEAN C (DR)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:C
Last Name:MCINTYRE
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1275 POWERS FERRY ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067
Mailing Address - Country:US
Mailing Address - Phone:770-952-9664
Mailing Address - Fax:770-952-2962
Practice Address - Street 1:1275 POWERS FERRY ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067
Practice Address - Country:US
Practice Address - Phone:770-952-9664
Practice Address - Fax:770-952-2962
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA006153111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
352CHDBMedicare UPIN