NPI 1295551240

Konnor Gerald Kingsmore, LATATC

Practitioner Athletic Trainer Menomonee Falls, WI

Practice location

Address: N91w15750 Falls Pkwy, Menomonee Falls, WI 53051-2301
Phone: (262) 532-1100
Mailing address: W64n14273 Washington Ave APT 129, Cedarburg, WI 53012-3035

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 3219-39 (WI)

Other Specialist/Technologist providers in Wisconsin →

Registry record

NPI: 1295551240
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Nov 2024
Record last updated: 25 Nov 2024

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.