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Kenneth Ildefonso, A.T.R
NPI 1518356427 · on the registry since 2015 · sole proprietor
Practice
- Address
- 1801 Monks Ave
Apartment 413
Mankato, MN 56001 - Phone
- (203) 584-3347
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- MN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-01-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota