Provider Demographics
NPI:1508920927
Name:ENSLINGER, DUSTIN (MS, ATC)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:
Last Name:ENSLINGER
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2931 RIO VISTA DR
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-5874
Mailing Address - Country:US
Mailing Address - Phone:435-881-6132
Mailing Address - Fax:620-341-6939
Practice Address - Street 1:1200 COMMERCIAL ST
Practice Address - Street 2:CAMPUS BOX 4020
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-5057
Practice Address - Country:US
Practice Address - Phone:620-341-5021
Practice Address - Fax:620-341-6939
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0703020692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer