Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. KENNETH ILDEFONSO JR., A.T.R
Active Sole ProprietorMR. KENNETH ILDEFONSO JR., A.T.R is a Athletic Trainer healthcare provider located in MANKATO, Minnesota. NPI 1518356427 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · MANKATO, MN
Registration Details
- NPI Number
- 1518356427
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 15, 2015 (11.561344033743 yrs)
- Last Updated
- Jan 15, 2015
- License
-
2474 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1801 MONKS AVEAPARTMENT 413MANKATO, MN, 560016356Browse MN providers · Browse ZIP 56001
- Phone
- 2035843347
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in MANKATO, MN
| Name | Credential | NPI |
|---|---|---|
| AMY MARIE BRUGGE | LAT, ATC | 1063409928 |
| MR. TROY LOUIS HOEHN | LAT, ATC, CSCS | 1396736138 |
| MR. PATRICK JAMES SEXTON I | ATC, ATR | 1619945631 |
| MRS. SARAH MERFELD DOWNEY | MS, ATC/R, CSCS | 1427017375 |
| MR. RANDALL KEITH PALMER | M.ED, A.T.C. | 1548229214 |
| MR. JASON WADE BUSHIE | ATC | 1174545180 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.