Healthcare Provider Details

I. General information

NPI: 1477718138
Provider Name (Legal Business Name): EKELE ENYINNAYA DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EKELE OYOYO

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 MASSACHUSETTS AVE NW
WASHINGTON DC
20005-4604
US

IV. Provider business mailing address

1115 MASSACHUSETTS AVE NW
WASHINGTON DC
20005-4604
US

V. Phone/Fax

Practice location:
  • Phone: 202-430-6075
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number0
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: