Provider Demographics
NPI:1407910672
Name:ENLOE, AMY LYNN
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:ENLOE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6746 HORSESHOE BND
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-9212
Mailing Address - Country:US
Mailing Address - Phone:608-845-9853
Mailing Address - Fax:
Practice Address - Street 1:7710 S BROOKLINE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-3511
Practice Address - Country:US
Practice Address - Phone:608-833-2017
Practice Address - Fax:608-833-2026
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant