Individual
SHANE MCINTYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
8971 W OVERLAND RD, BOISE, ID 83709-1651
(208) 378-4288
(208) 378-4297
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 955-6522
(208) 955-6503
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TLP-034
ID
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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