Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JUSTIN R ENNIS
ActiveJUSTIN R ENNIS is a Sports Medicine (EM) healthcare provider located in PORTALES, New Mexico. NPI 1023527314 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (EM) · PORTALES, NM
Registration Details
- NPI Number
- 1023527314
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 29, 2017 (8.9089389054131 yrs)
- Last Updated
- Sep 29, 2017
- License
-
720 (NM)
Practice Information
- Address
-
1500 S AVENUE KPORTALES, NM, 881307400Browse NM providers · Browse ZIP 88130
- Phone
- 7605252087
- Primary Specialty
-
Sports Medicine (EM)
207PS0010X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.