Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenneth Dildine Jr., ATC, LAT

Individual provider Athletic Trainer · NPI 1952880023

Kenneth Dildine Jr., ATC, LAT is an Athletic Trainer in O Fallon, Missouri. Licensed in Missouri. Registered with an NPI since 2018.

Licensed in
MO
In the registry since
2018
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

See every abbreviation used in this directory →

Practice location Address checks out

1230 Tom Ginnever Ave
O Fallon, MO 63366-4406
Phone: (636) 359-8884
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 2018024370 (MO)

Record details

NPI number1952880023
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC , LAT
Sole proprietorNo
NPI enumeratedAugust 9, 2018
Last updated in NPPESMay 16, 2023
Certification dateMay 16, 2023

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