Individual
WILLIAM A ENNIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5125 N 58TH AVE, GLENDALE, AZ 85301-7453
(623) 931-5800
Mailing address
38612 N 25TH AVE, PHOENIX, AZ 85086-0539
(623) 363-9198
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
12377A
AZ
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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