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Matthew Enzweiler
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NPI Number Detailed Information
Provider Information:
| Name: | Matthew Enzweiler |
| Gender: | M |
| Provider License Number If Given: | 223 |
NPI Information:
| NPI: | 1023017522 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/18/2005 |
| Last Update Date: | 9/6/2018 |
Provider Business Mailing Address:
| Address: | PO BOX 635283 Cincinnati, OH 45263 |
| Phone Number: | 8592120175 |
| Fax Number: | 8597467464 |
Provider Business Practice Location Address:
| Address: | 525 ALEXANDRIA PIKE SUITE 230 Southgate, KY 41071 |
| Phone Number: | 8594414334 |
| Fax Number: | 8594413698 |
Provider Taxonomy:
| Primary: | 213ES0103X |
| Secondary (if any): | |
| State: | KY |
