Mcintyre, Jesse Wade

Mcintyre, Jesse Wade is an individual health care provider with primary practice located at 210 La Salle Dr , San Angelo TX 76903-7916. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Mcintyre, Jesse Wade can be contacted via phone (405) 614-2024.

Contact Information

Primary practice address
210 La Salle Dr San Angelo TX 76903-7916
Phone: (405) 614-2024
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X AT7626 Texas
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X AT003021 Georgia

Profile Details

NPI number 1477063725
LBN Legal business name Mcintyre, Jesse Wade
Credentials DAT, LAT, ATC, CSCS
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2017
Last updated Nov 28th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477063725 NPPES
Georgia Other AT003021 ATHLETIC TRAINER CERTIFIED AND LICENSED

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