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Contact Information

MICUM K MCINTIRE, MS, ATC, OTC
789 PINE ST
BURLINGTON, VT05401-4933
 Phone: 802-264-1052
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for MICUM K MCINTIRE · (Male)

NPI # 1497764658
Status Active
Credentials MS, ATC, OTC
Entity Individual
Enumeration date 08/05/2006
Last updated 07/06/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • NH License # 0363
  • NH License # 09-0203
  • VT License # 104.0000165
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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