Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics |
NPI | 1043890130 |
---|---|
Provider Name | Lauren Mcintosh |
First Address | Mott, ND 58646-7563 |
Second Address | Mott, ND 58646-7270 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2021 |
Last Update Date | 12/04/2021 |