Mr. Kenneth Ildefonso Jr., ATR
Mr. Kenneth Ildefonso Jr., ATR is an Athletic Trainer in Mankato, Minnesota. Practices as a sole proprietor. Licensed in Minnesota.
- Licensed in
- MN
- In the registry since
- 2015
Practice location Address checks out
1801 Monks Ave Apt 413Mankato, MN 56001-6356
Phone: (203) 584-3347
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Athletic Trainer (primary) | Taxonomy 2255A2300X · Licence 2474 (MN) |
|---|
Record details
| NPI number | 1518356427 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | ATR |
| Sole proprietor | Yes |
| NPI enumerated | January 15, 2015 |
| Last updated in NPPES | January 15, 2015 |
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