NPI 1124610597

Samual Dean Kotsonas

Practitioner Athletic Trainer Kenosha, WI

Practice location

Address: 2001 Alford Dr, Kenosha, WI 53140-1927
Phone: (952) 300-7222
Mailing address: 14521 Genesee Ave, Apple Valley, MN 55124-8420

Registered specialties (2)

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1124610597
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Feb 2021
Record last updated: 8 Feb 2021

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.