Provider Demographics
NPI:1023852373
Name:ENSOR, ERINN
Entity type:Individual
Prefix:
First Name:ERINN
Middle Name:
Last Name:ENSOR
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 1:24304 MONROE ROAD 217
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAY
Mailing Address - State:MO
Mailing Address - Zip Code:65258-2203
Mailing Address - Country:US
Mailing Address - Phone:660-651-6230
Mailing Address - Fax:
Practice Address - Street 1:318 W COATES ST STE 105
Practice Address - Street 2:
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-1598
Practice Address - Country:US
Practice Address - Phone:660-651-5881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist