Provider Demographics
NPI:1669019568
Name:ENSO PLLC
Entity Type:Organization
Organization Name:ENSO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:COOK-BRETSON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, LMT
Authorized Official - Phone:406-585-9113
Mailing Address - Street 1:875 BRIDGER DR UNIT J
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-2303
Mailing Address - Country:US
Mailing Address - Phone:406-585-9113
Mailing Address - Fax:406-585-9103
Practice Address - Street 1:875 BRIDGER DR UNIT J
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-2303
Practice Address - Country:US
Practice Address - Phone:406-585-9113
Practice Address - Fax:406-585-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty