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1891960837
MATTHEW LOUIS ENNIS
BRADENTON, FL
NPI
1891960837
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: FL AL 796)
Enumeration Date
2008-04-29
Last Update Date
2008-04-29
Business Address
-- MATTHEW LOUIS ENNIS A.T.,C.
5840 26TH ST W
BRADENTON, FL 34207-3522
Phone number: 941-752-5574
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Mailing Address
-- MATTHEW LOUIS ENNIS A.T.,C.
4104 1ST AVE W
BRADENTON, FL 34209-2057
Phone number: 941-238-8592
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