Provider Demographics
NPI:1104816503
Name:MCINTIRE, MARSHA LEE (PT)
Entity type:Individual
Prefix:
First Name:MARSHA
Middle Name:LEE
Last Name:MCINTIRE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3710 STATE ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3134
Mailing Address - Country:US
Mailing Address - Phone:805-682-7777
Mailing Address - Fax:805-682-3223
Practice Address - Street 1:3710 STATE ST
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3134
Practice Address - Country:US
Practice Address - Phone:805-682-7777
Practice Address - Fax:805-682-3223
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 15714225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT15714Medicare PIN