NPI 1114372752

Ryan Scott Fonkert, MSATC

Practitioner Athletic Trainer Fayette, IA

Practice location

Address: 605 Washingtone Street, Fayette, IA 52142
Phone: (563) 425-5664
Fax: (563) 425-5188
Mailing address: 108 Eliasen Ave, Waverly, IA 50677-4415

Registered specialties (2)

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 084678 (IA)

Other Specialist/Technologist providers in Iowa →

Athletic Trainer

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 586 (CO)

Registry record

NPI: 1114372752
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 May 2016
Record last updated: 27 Mar 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.