Individual
SPENCER LEWISTON MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
800 E LANCASTER AVE, VILLANOVA, PA 19085-1603
(610) 519-4500
Mailing address
25 JONI CIR, DOUGLASSVILLE, PA 19518-9359
(610) 780-7168
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT008218
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
11/23/2021
Last updated
07/28/2023
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