| Doctor Name: | MR. CHAD P ENICH |
| NPI Number: | 1174510879 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA C |
| License Number: | 001165 |
| Business Practice Address: | 2901 86th St Urbandale, IA - 503224201 |
| Business Phone Number: | 5152763406 |
| Business Fax Number: | 5152765141 |
| Mailing Address: | 2901 86th St, URBANDALE |
| State: | IA |
| Postal Code: | 503224201 |
| Phone Number: | 5152763406 |
| Fax Number: | 5152765141 |
| NPI Enumeration Date: | 09/29/2005 |
| NPI Last Update Date: | 02/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146N00000X |
| License Number: | 001165 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Basic |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |