Provider Demographics
NPI:1053511964
Name:ENYART, JAMES DAVID (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DAVID
Last Name:ENYART
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9454 W MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62223-1729
Mailing Address - Country:US
Mailing Address - Phone:618-397-4700
Mailing Address - Fax:618-397-4707
Practice Address - Street 1:9454 W MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62223-1729
Practice Address - Country:US
Practice Address - Phone:618-397-4700
Practice Address - Fax:618-397-4707
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL03010976111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor