Individual
DAVID CHANDLER ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
100 KELLIE DR, SMITHFIELD, NC 27577-9444
(919) 220-5255
Mailing address
PO BOX 5105, BELFAST, ME 04915-5100
(919) 220-5255
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P21674
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P21674
PT LICENSE
NC
Enumeration date
09/26/2022
Last updated
09/26/2022
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