Individual
MR. JOSEPH B KINGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC/L
Contact information
Practice address
1505 EASTLAND DR STE 220, BLOOMINGTON, IL 61701-7906
(309) 662-2278
Mailing address
1211 SEARLE DR, NORMAL, IL 61761-2866
(630) 742-8851
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003496
IL
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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