Justin R Ennis
NPI #1023527314 in Portales, New Mexico
Provider Information
- NPI Number
- 1023527314
- Entity Type
- Individual
- Name
- Justin R Ennis
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Emergency Medicine - Sports Medicine
- Enumeration Date
- Sep 29, 2017
- Last Updated
- Sep 29, 2017
Practice Location
- Address
- 1500 S AVENUE K
- City
- Portales
- State
- New Mexico
- ZIP Code
- 88130-7400
- Phone
- (760) 525-2087
Specialties & Taxonomy Codes
| Specialty |
|---|
| Emergency Medicine - Sports Medicine — Sports Medicine |
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