Individual
MR. IAN ROBERT MCINTIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPO, CPO
Contact information
Practice address
1 JEFFERSON BARRACKS DR, SAINT LOUIS, MO 63125-4181
(314) 652-4100
Mailing address
127 MADISON AVE, WEBSTER GROVES, MO 63119-1603
(954) 651-3043
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
CPO04181
MO
224P00000X
Prosthetist
CPO04181
MO
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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