KENNETH DILDINE

O FALLON, MO
NPI1952880023
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO  2018024370)
Enumeration Date2018-08-09
Last Update Date2023-05-16
Business Address
KENNETH DILDINE ATC, LAT
1230 TOM GINNEVER AVE
O FALLON, MO 63366-4406
Phone number: 636-359-8884
Mailing Address
KENNETH DILDINE ATC, LAT
25 DEER RUN TRL
NEW FLORENCE, MO 63363-3519
Phone number: 636-359-8884