Individual
TIFANI VERONICA ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
50 WYNTRE BROOKE DR, YORK, PA 17403-4535
(717) 812-5626
(717) 741-0879
Mailing address
208 S FRONT ST, WRIGHTSVILLE, PA 17368-1613
(717) 332-6026
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MSG005993
PA
Other
Enumeration date
12/04/2013
Last updated
12/04/2013
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