Provider Demographics
NPI:1992403083
Name:MCINTYRE, JAYCI MARIE (ATC)
Entity type:Individual
Prefix:
First Name:JAYCI
Middle Name:MARIE
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7380 SPOUT SPRINGS ROAD
Mailing Address - Street 2:STE 210 BOX 232
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542
Mailing Address - Country:US
Mailing Address - Phone:678-735-8880
Mailing Address - Fax:
Practice Address - Street 1:6271 BAY LN
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-6410
Practice Address - Country:US
Practice Address - Phone:678-735-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program