Provider Demographics
NPI:1023361326
Name:ENRIGHT, KEMIS IRENE (PTA)
Entity Type:Individual
Prefix:
First Name:KEMIS
Middle Name:IRENE
Last Name:ENRIGHT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9424 PENNY LN
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AR
Mailing Address - Zip Code:72949-8157
Mailing Address - Country:US
Mailing Address - Phone:479-213-3495
Mailing Address - Fax:
Practice Address - Street 1:9424 PENNY LANE
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AR
Practice Address - Zip Code:72949-8157
Practice Address - Country:US
Practice Address - Phone:479-213-3495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPTA2101174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist