JUSTIN R ENNIS

PORTALES, NM
NPI1023527314
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207PS0010X Emergency Medicine, Sports Medicine
(Licence: NM  720)
Enumeration Date2017-09-29
Last Update Date2017-09-29
Business Address
JUSTIN R ENNIS
1500 S AVENUE K
PORTALES, NM 88130-7400
Phone number: 760-525-2087
Mailing Address
JUSTIN R ENNIS
1500 S AVENUE K # 17
PORTALES, NM 88130-7400
Phone number:
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