Provider Demographics
NPI:1518167402
Name:ENYOBI, ROBERT OKWY (PT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:OKWY
Last Name:ENYOBI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 W 56TH PL
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-2034
Mailing Address - Country:US
Mailing Address - Phone:219-980-2928
Mailing Address - Fax:
Practice Address - Street 1:433 W 56TH PL
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-2034
Practice Address - Country:US
Practice Address - Phone:219-980-2928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05003450A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist