Provider Demographics
NPI:1053540641
Name:MCINTOSH, LEARY DEAN D (MPT)
Entity type:Individual
Prefix:MR
First Name:LEARY DEAN
Middle Name:D
Last Name:MCINTOSH
Suffix:
Gender:M
Credentials:MPT
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Mailing Address - Street 1:2531 ROCKY RIDGE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-4415
Mailing Address - Country:US
Mailing Address - Phone:205-978-7376
Mailing Address - Fax:205-978-0861
Practice Address - Street 1:1811 DAHLKE DR
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-3625
Practice Address - Country:US
Practice Address - Phone:256-739-1370
Practice Address - Fax:256-739-1956
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2017-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY031431-1225100000X
FL26290225100000X
ALPTH8375225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist