Search › New Mexico › 207PS0010X
Justin Ennis
NPI 1023527314 · on the registry since 2017
Practice
- Address
- 1500 S Avenue K
Portales, NM 88130 - Phone
- (760) 525-2087
- Organisation at this address
- Regional Education Center
Eastern New Mexico University
Regional Educational Center #6Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 127
Registry record
- Primary taxonomy
- 207PS0010X
207PS0010X
- Licence states on file
- NM
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2017-09-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Mexico