Justin R Ennis
Justin R Ennis is a Sports Medicine (Emergency Medicine) Physician in Portales, New Mexico. Licensed in New Mexico. Registered with an NPI since 2017.
- Licensed in
- NM
- In the registry since
- 2017
Practice location Address checks out
1500 S Avenue KPortales, NM 88130-7400
Phone: (760) 525-2087
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Sports Medicine (Emergency Medicine) Physician (primary) | Taxonomy 207PS0010X · Licence 720 (NM) |
|---|
Record details
| NPI number | 1023527314 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | September 29, 2017 |
| Last updated in NPPES | September 29, 2017 |