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Individual

MRS. DANETTA MICHELLE ENNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, ATC, LAT

Contact information

Practice address
1416 E MATTHEWS AVE STE 200, JONESBORO, AR 72401-4362
(870) 932-1820
(870) 972-6712
Mailing address
1416 E MATTHEWS AVE STE 200, JONESBORO, AR 72401-4362
(870) 932-1820
(870) 972-6712

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AR

Other

Enumeration date
05/19/2017
Last updated
07/21/2022
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