Individual
KEVIN D ENSENAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
94 VALLEY RD, MONTCLAIR, NJ 07042-2211
(201) 788-2666
Mailing address
257 E 7TH ST, CLIFTON, NJ 07011-1712
(201) 788-2666
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT01439200
NJ
Other
Enumeration date
06/19/2024
Last updated
06/19/2024
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