Provider Demographics
NPI:1366977118
Name:ENGLE, IAN
Entity type:Individual
Prefix:
First Name:IAN
Middle Name:
Last Name:ENGLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 771475
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80477-1475
Mailing Address - Country:US
Mailing Address - Phone:970-871-4838
Mailing Address - Fax:970-481-4841
Practice Address - Street 1:1306 LINCOLN AVE UNIT A
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-5030
Practice Address - Country:US
Practice Address - Phone:970-871-4838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications
No175T00000XOther Service ProvidersPeer Specialist