MR. Jonathon Lee Ennis, PAC

NPI #1497267637 in Springfield, Kentucky

Provider Information

NPI Number: 1497267637
Entity Type: Individual
Name: MR. Jonathon Lee Ennis, PAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PAC
Enumeration Date: Oct 27, 2017
Last Updated: Mar 28, 2019

Practice Location

Address: 805 BARDSTOWN RD
City: Springfield
State: Kentucky
ZIP Code: 40069
Phone: (859) 481-7113

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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