Provider Demographics
NPI:1053831677
Name:ENKE, MATTHEW AARON
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:AARON
Last Name:ENKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 PARSONS ST
Mailing Address - Street 2:
Mailing Address - City:ROBINSON
Mailing Address - State:KS
Mailing Address - Zip Code:66532-9774
Mailing Address - Country:US
Mailing Address - Phone:785-741-3065
Mailing Address - Fax:
Practice Address - Street 1:402 PARSONS ST
Practice Address - Street 2:
Practice Address - City:ROBINSON
Practice Address - State:KS
Practice Address - Zip Code:66532-9774
Practice Address - Country:US
Practice Address - Phone:785-741-3065
Practice Address - Fax:785-741-3065
Is Sole Proprietor?:No
Enumeration Date:2017-06-24
Last Update Date:2017-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer