Provider Demographics
NPI:1467706994
Name:ETNOYER, JENA LYNNE (ATC)
Entity Type:Individual
Prefix:
First Name:JENA
Middle Name:LYNNE
Last Name:ETNOYER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9300 LIVINGSTON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4914
Mailing Address - Country:US
Mailing Address - Phone:301-251-2777
Mailing Address - Fax:
Practice Address - Street 1:827 ROCKVILLE PIKE STE E
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1267
Practice Address - Country:US
Practice Address - Phone:301-251-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-06
Last Update Date:2012-12-10
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer