Martin Dale McIntosh, D.C.
Individual provider Active NPI Chiropractor · Rogue River, OR
NPI 1508049263 · NPPES record last updated Mar 18, 2009
Key facts
- NPI
- 1508049263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1712 (OR)
- Practice address
- 374 Covered Bridge Rd
Rogue River, OR 97537-6603 - Phone
- (902) 581-7497
- Fax
- (541) 582-1972
- NPI assigned
- Dec 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1712 | OR | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Integrative Care, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1712 | OR | Yes |
Addresses
Primary practice location
374 Covered Bridge Rd
Rogue River, OR 97537-6603
Mailing address
374 Covered Bridge Rd
Rogue River, OR 97537-6603
Phone (902) 581-7497
Other providers in Rogue River, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.